Seers Kate, Crichton Nicola, Tutton Liz, Smith Lisa, Saunders Teresa
RCN Research Institute, School of Health and Social Studies, University of Warwick, Coventry, UK.
J Adv Nurs. 2008 Jun;62(6):681-8. doi: 10.1111/j.1365-2648.2008.04642.x.
This paper is a report of a study to determine the effectiveness of jaw and total body relaxation for postoperative pain, anxiety and level of relaxation, and to determine any patient expectancy effects.
Relaxation is increasingly suggested as a pain control technique that can be used by nurses in daily practice. A systematic review of the effectiveness of relaxation for postoperative pain relief revealed many poorly designed studies and only some weak evidence supporting the use of relaxation for postoperative pain.
A randomized controlled trial (n = 118) was conducted between 2002 and 2003 to compare total body relaxation, jaw relaxation, attention control and usual care. Consenting patients admitted for elective orthopaedic surgery aged 18 or over, able to speak English and able to tense and relax more than two muscle groups were included. Pain at rest and on movement, anxiety and relaxation were assessed at pre-admission clinic, pre-intervention, immediately post-intervention and 1, 2, 3 and 4 hours later. However, the trial was under-powered.
There were statistically significant reductions in pain at rest from pre- to post-intervention for both the relaxation groups and the attention control group. The usual care group had a small increase in pain, whilst the other three groups had similar small decreases in pain. There was no statistically significant difference in anxiety or relaxation scores pre- to post-intervention between groups.
Jaw relaxation could give these orthopaedic patients a small, very short-lasting additional amount of pain relief, and it may be that staff and patients feel this small benefit to be worthwhile.
本文报告一项研究,以确定颌部及全身放松对术后疼痛、焦虑和放松程度的效果,并确定是否存在患者期望效应。
越来越多的人建议将放松作为一种疼痛控制技术,护士可在日常实践中使用。一项关于放松对术后疼痛缓解效果的系统评价发现,许多研究设计不佳,仅有一些微弱证据支持使用放松来缓解术后疼痛。
2002年至2003年进行了一项随机对照试验(n = 118),比较全身放松、颌部放松、注意力控制和常规护理。纳入年龄在18岁及以上、同意参与的择期骨科手术患者,这些患者能说英语,能够对两组以上肌肉群进行紧张和放松操作。在入院前门诊、干预前、干预后即刻以及1、2、3和4小时后评估静息和活动时的疼痛、焦虑和放松情况。然而,该试验样本量不足。
干预前后,放松组和注意力控制组的静息疼痛均有统计学意义的显著降低。常规护理组疼痛略有增加,而其他三组疼痛均有类似的小幅下降。组间干预前后焦虑或放松评分无统计学意义的差异。
颌部放松可为这些骨科患者带来少量、非常短暂的额外疼痛缓解,医护人员和患者可能认为这种小益处是值得的。