Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota, USA.
Brain Behav. 2024 Jul;14(7):e3640. doi: 10.1002/brb3.3640.
Effective pain and anxiety management during the perioperative phase remains a challenge for patients undergoing surgeries and other invasive procedures. The current standard of care involves prescribing analgesics to treat these conditions; however, there has been recent interest in applying multimodal strategies that limit the use of these medications. One such modality is meditation, which has been shown to be effective in alleviating various physical and psychological symptoms in other settings. This systematic review aims to assess how current meditative practices affect perioperative pain and anxiety.
We conducted a systematic review of randomized controlled trials following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted using PubMed MEDLINE, Embase, PsycINFO, APA PsycINFO, EBM Reviews, Scopus, and Web of Science for all available dates. Our primary outcomes of interest were patient-reported pain and anxiety scores using the Visual Analog Scale, the Brief Pain Inventory, the Depression Anxiety Stress Scale, the State-Trait Anxiety Inventory (STAI), and the Hospital Anxiety and Depression Scale (HADS). For the HADS and STAI scales, only the anxiety and anxiety-state subgroups were reported, respectively.
The literature search yielded 1746 articles. A total of 286 full-text articles were screened, and 16 studies were included in this systematic review. A total of eight studies assessed pain scores after invasive procedures; five reported improvements in pain scores, and three reported no change after meditative practices. Ten studies assessed anxiety outcomes after invasive procedures: nine reported a decrease in overall anxiety levels as a result of meditation practices while one study reported no change in anxiety scores.
Data from this limited literature suggests that different meditation practices could be effective in alleviating pain and anxiety within the perioperative phase for patients undergoing various types of invasive procedures. Future prospective studies are needed to determine whether routine meditation in the perioperative setting is effective in mitigating perioperative pain and anxiety.
在接受手术和其他侵入性操作的患者中,有效管理围手术期疼痛和焦虑仍然是一个挑战。目前的治疗标准包括开具镇痛药来治疗这些疾病;然而,最近人们对应用限制这些药物使用的多模式策略产生了兴趣。其中一种方法是冥想,它已被证明在其他环境中有效缓解各种身体和心理症状。本系统评价旨在评估当前的冥想实践如何影响围手术期疼痛和焦虑。
我们按照系统评价和荟萃分析的首选报告项目指南进行了系统评价。使用 PubMed MEDLINE、Embase、PsycINFO、APA PsycINFO、EBM Reviews、Scopus 和 Web of Science 对所有可用日期进行了全面的文献检索。我们感兴趣的主要结果是使用视觉模拟量表、简要疼痛量表、抑郁焦虑压力量表、状态特质焦虑量表(STAI)和医院焦虑抑郁量表(HADS)报告的患者报告的疼痛和焦虑评分。对于 HADS 和 STAI 量表,仅报告了焦虑和焦虑状态亚组。
文献检索产生了 1746 篇文章。共筛选了 286 篇全文文章,16 项研究纳入本系统评价。共有 8 项研究评估了侵入性手术后的疼痛评分;五项报告疼痛评分有所改善,三项报告冥想后疼痛评分无变化。十项研究评估了侵入性手术后的焦虑结果:九项研究报告冥想实践导致总体焦虑水平降低,一项研究报告焦虑评分无变化。
这项有限的文献数据表明,不同的冥想实践可能在缓解接受各种类型侵入性操作的患者围手术期疼痛和焦虑方面有效。需要未来的前瞻性研究来确定围手术期常规冥想是否能有效减轻围手术期疼痛和焦虑。