Psychological Methods of Managing Surgical Pain

In patients who experience chronic or acute wound pain, analgesic requirements as well as patient-centered and clinical outcomes can be affected by psychological interventions as explored by considerable research. Psychological interventions are classified as procedural: informing patients of wound or surgery procedures; sensory: describing how the wound or procedure will feel; behavioral: telling patients what to do to facilitate procedures or recovery; cognitive: coaching patients how to think more positively about the wound or procedure; relaxation: systematic muscle relaxing and/or breathing techniques; hypnosis: suggesting changes in patient perceptions; mindfulness: techniques based on meditation or contemplation; emotional: methods of coping with stress related to the wound or procedure; or patient-generated narratives focusing on the procedure or wound. These interventions are often used alongside analgesics or anesthetics. Evidence suggests that various psychological interventions may be effective in managing chronic pain lasting 3 or more months. In June 2020, a planned systematic review exploring their interactions with pharmacologic agents in managing chronic nonspecific lower back pain was announced. Pilot research has initiated a randomized controlled trial (RCT) testing the value of mindfulness training for military veterans dealing with chronic pain. In this installment of Evidence Corner, 2 recent systematic reviews that explored whether such interventions improve patients' experiences or clinical outcomes for those undergoing abdominal and general1 surgery are reviewed.