Nonpharmacological methods of pain relief after onco-surgeries: Study finds the answer

Postoperative pain is a common but undesirable outcome following surgery. It is crucial to effectively manage postoperative pain to facilitate proper recovery and minimize the negative effects of unmanaged pain. Recent prospective, observational study aimed to assess the use of nonpharmacological methods (NPMs) for postoperative pain management among patients following oncologic surgeries at a single center.

The primary objective was to determine the incidence of NPM use, while secondary objectives were to correlate NPM use with pain scores, patient satisfaction, and physical/emotional outcomes. The study included 200 adult patients who underwent major elective surgeries and were followed for the first 72 hours after surgery. Patients were interviewed on the third postoperative day to assess their use of NPMs, beliefs about NPMs, and responses to the American Pain Society Patient Outcome Questionnaire (APS-POQ). The results showed that only 24.5% of the total study population used NPMs for postoperative pain relief. The most common NPMs used were prayer (11.5%), deep breathing (6%), and watching TV/reading (5-6%). When not in pain, 46% of patients reported using NPMs as part of their hospital routine, most commonly walking (23.5%), deep breathing (14%), and prayer (18.5%).

After propensity matching patients based on surgery type and postoperative analgesia, there were no significant differences in pain scores, patient satisfaction, or physical/emotional outcomes between those who used NPMs and those who did not. Patients who did not use NPMs when in pain tended to spend less time (20% vs 30%) in severe pain compared to the NPM group, though this difference was not statistically significant.

The study found that education level impacted patients' beliefs and willingness to use NPMs, with more educated patients having a more positive view. However, overall, only 35% of patients believed in the benefits of NPMs for pain management, and 48% agreed to participate in NPMs after being informed of their potential usefulness. In conclusion, the use of NPMs for postoperative pain management was low in this patient population, with no clear benefits observed in pain scores, satisfaction, or outcomes. Lack of caregiver encouragement and low patient awareness about the benefits of NPMs appear to be key barriers. Improving education, particularly among less educated patients, may help increase the utilization of these complementary pain management techniques.

Key Points

Here are the 6 key points from the research paper:

1. The study aimed to assess the use of nonpharmacological methods (NPMs) for postoperative pain management in patients following oncologic surgeries.

2. The results showed that only 24.5% of the total study population used NPMs for postoperative pain relief, with the most common methods being prayer (11.5%), deep breathing (6%), and watching TV/reading (5-6%).

3. When not in pain, 46% of patients reported using NPMs as part of their hospital routine, with the most common methods being walking (23.5%), deep breathing (14%), and prayer (18.5%).

4. There were no significant differences in pain scores, patient satisfaction, or physical/emotional outcomes between those who used NPMs and those who did not, though patients who did not use NPMs when in pain tended to spend less time in severe pain.

5. The study found that education level impacted patients' beliefs and willingness to use NPMs, with more educated patients having a more positive view, but overall, only 35% of patients believed in the benefits of NPMs for pain management.

6. The low utilization of NPMs appears to be due to a lack of caregiver encouragement and low patient awareness about the benefits of these complementary pain management techniques, suggesting that improving education, particularly among less educated patients, may help increase their use.

Reference –

Bakshi SG, Arya K, Dhurwe B. Prevalence of use of nonpharmacological methods of pain relief among patients following onco surgeries – A prospective, observational cohort study from a single center. J Anaesthesiol Clin Pharmacol 2024 DOI: 10.4103/joacp.joacp_198_22