Therapeutic Suggestion in Postoperative Pain Control: A Randomized Controlled Trial.
Therapeutic Suggestion in Postoperative Pain Control: A Randomized Controlled Trial.
- 2021
CONCLUSIONS: No differences in postoperative pain, analgesic use, return of bowel and bladder function, or pelvic organ prolapse symptoms were noted in participants receiving perioperative therapeutic suggestion versus routine perioperative care. METHODS: This was a single-blinded, randomized controlled trial of participants undergoing vaginal hysterectomy with minimally invasive sacrocolpopexy and concomitant prolapse repairs. The intervention group received perioperative therapeutic suggestion, whereas the control group did not. Primary outcomes included postoperative pain scores and analgesic use. Secondary outcomes included a postoperative nausea and vomiting scale, the Pelvic Floor Distress Inventory Questionnaire-Short Form 20, the Patient Global Impression of Improvement scale, and time to return of bowel and bladder function. OBJECTIVES: There is conflicting research on the effect of therapeutic suggestion in the perioperative period. This study systematically compared subjective and objective measures of postoperative pain, nausea and vomiting, urinary and bowel function, and global perception of symptomatic improvement between participants receiving perioperative therapeutic suggestion versus routine perioperative care during minimally invasive pelvic reconstructive surgery. RESULTS: Sixteen participants were randomized to each group. Final analysis included 15 intervention and 14 control participants. Overall measures of postoperative pain and analgesic use were low across all participants without a significant difference between intervention and control groups (opioid: 52.5; interquartile range [IQR], 25.5-58.9 vs 66 IQR, 7.3-125.8; morphine milligram equivalents; P = 0.64; acetaminophen: 2225 mg; IQR, 500-2600 mg vs 2800 mg; IQR, 650-4775 mg; P = 0.38). There were no statistically significant differences in secondary outcomes of urinary symptoms, bowel function, and subjective improvement of prolapse symptoms.
English
2151-8378
10.1097/SPV.0000000000000906 [doi]
*Hysterectomy, Vaginal/ae [Adverse Effects]
*Pain, Postoperative/px [Psychology]
*Postoperative Nausea and Vomiting/px [Psychology]
*Preoperative Care/px [Psychology]
Female
Humans
Hysterectomy, Vaginal/px [Psychology]
Middle Aged
Pain Measurement
Pain, Postoperative/pc [Prevention & Control]
Pelvic Organ Prolapse/su [Surgery]
Postoperative Nausea and Vomiting/pc [Prevention & Control]
Preoperative Care/mt [Methods]
Single-Blind Method
Surveys and Questionnaires
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
Journal Article
CONCLUSIONS: No differences in postoperative pain, analgesic use, return of bowel and bladder function, or pelvic organ prolapse symptoms were noted in participants receiving perioperative therapeutic suggestion versus routine perioperative care. METHODS: This was a single-blinded, randomized controlled trial of participants undergoing vaginal hysterectomy with minimally invasive sacrocolpopexy and concomitant prolapse repairs. The intervention group received perioperative therapeutic suggestion, whereas the control group did not. Primary outcomes included postoperative pain scores and analgesic use. Secondary outcomes included a postoperative nausea and vomiting scale, the Pelvic Floor Distress Inventory Questionnaire-Short Form 20, the Patient Global Impression of Improvement scale, and time to return of bowel and bladder function. OBJECTIVES: There is conflicting research on the effect of therapeutic suggestion in the perioperative period. This study systematically compared subjective and objective measures of postoperative pain, nausea and vomiting, urinary and bowel function, and global perception of symptomatic improvement between participants receiving perioperative therapeutic suggestion versus routine perioperative care during minimally invasive pelvic reconstructive surgery. RESULTS: Sixteen participants were randomized to each group. Final analysis included 15 intervention and 14 control participants. Overall measures of postoperative pain and analgesic use were low across all participants without a significant difference between intervention and control groups (opioid: 52.5; interquartile range [IQR], 25.5-58.9 vs 66 IQR, 7.3-125.8; morphine milligram equivalents; P = 0.64; acetaminophen: 2225 mg; IQR, 500-2600 mg vs 2800 mg; IQR, 650-4775 mg; P = 0.38). There were no statistically significant differences in secondary outcomes of urinary symptoms, bowel function, and subjective improvement of prolapse symptoms.
English
2151-8378
10.1097/SPV.0000000000000906 [doi]
*Hysterectomy, Vaginal/ae [Adverse Effects]
*Pain, Postoperative/px [Psychology]
*Postoperative Nausea and Vomiting/px [Psychology]
*Preoperative Care/px [Psychology]
Female
Humans
Hysterectomy, Vaginal/px [Psychology]
Middle Aged
Pain Measurement
Pain, Postoperative/pc [Prevention & Control]
Pelvic Organ Prolapse/su [Surgery]
Postoperative Nausea and Vomiting/pc [Prevention & Control]
Preoperative Care/mt [Methods]
Single-Blind Method
Surveys and Questionnaires
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
Journal Article