Some medical procedures and surgical operations allow, in some cases even require, that a patient remain awake. A new study compares how effective different distraction interventions are in reducing levels of anxiety and pain when patients undergo such procedures. Using stress balls, talking to a nurse, and watching a DVD eased the surgical patients’ anxiety while also reducing their pain, the University of Surrey researchers discovered.

“Patients and health care providers should be aware of these findings to allow them to make informed decisions regarding the management of intraoperative pain and anxiety,” wrote the authors in their published report. “At the very least, none of the interventions studied worsened patient experience. Therefore we support their use, or the option of their use in routine practice.”

Test Surgery: Varicose Vein Treatments

Commonly, varicose veins — gnarled, enlarged veins in the legs and feet — occur in women during pregnancy, due to the sudden excess weight and the pressure it causes. Varicose vein treatments include in office procedures where problem veins are closed off or removed. Requiring only a local anesthetic, the patient remains awake throughout these procedures, so they are fully aware of everything, including conversations between doctors and nurses about distressing surgical details. Often, patients experience pain in the form of a burning sensation in addition to anxiety.

While unpleasant, these conditions suggested a perfect experiment for exploring alternative options for treating pain and anxiety. And so the University of Surrey researchers began the current study by enlisting the help of 398 patients about to undergo varicose vein surgeries.

After splitting the patients into four groups, the researchers offered each group a different non-drug intervention to help ease anxiety and pain. During their surgeries, patients in the first group listened to music, while patients in the second group watched a DVD. Patients in the third group enjoyed a conversation with a nurse and those in the fourth group squeezed palm-sized stress balls. Immediately after the operation, the patients recorded their anxiety and levels via a short questionnaire.

After tallying the results, the researchers compared each group's experience with patients who received treatment as usual.

  • Sadly — surprisingly! — music did not ease patients’ feelings of anxiety or pain whatsoever.
  • Patients who watched a DVD showed 25 percent less anxiety than patients receiving treatment as usual, yet, they reported no reduction in pain.
  • The patients who quietly talked to a nurse throughout their surgeries reported 30 percent less anxiety and 16 percent less pain than treatment-as-usual patients.
  • Finally, the patients who used stress balls reported 18 percent less anxiety and the greatest reduction in pain of all — 22 percent less than those who received treatment as usual.

Noting no significant impact to patient satisfaction, the researchers suggest intraoperative distractions be adopted for use during other conscious surgeries and procedures, including colonoscopies. They also recommend further research of these techniques applied to wound healing and recovery.

Source: Hudson BF, Ogden J, Whiteley MS. Randomised Controlled Trial to Compare the Effect of Simple Distraction Interventions on Pain and Anxiety Experienced During Conscious Surgery. European Journal of Pain. 2015.