Non-Pharmacological Methods and Post-Operative Pain Relief: An Observational Study

Anesth Pain Med. 2019 Apr 20;9(2):e84674. doi: 10.5812/aapm.84674. eCollection 2019 Apr.


Background: Non-pharmacological methods (NPMs) like cold packs, acupuncture, meditation or distractions are supposed to ease acute post-surgical pain.

Objectives: This study assessed how frequently these methods are used in clinical routine and if their use is associated with pain relief or with the wish for more pain treatment.

Methods: Data from the world's largest acute post-operative pain registry, PAIN OUT, was used for this study. In PAIN OUT, patients report their pain levels and side effects related to pain therapy after surgery. Overall, 15 different NPMs were tested for their association with pain relief and the wish for more pain treatment using Mann-Whitney U test, Kruskal-Wallis test, General Linear Model, and Logistic Regression. The researchers adjusted for age and gender, and specifically looked at the three most frequent surgeries: total knee replacement, total hip replacement, and laparoscopic cholecystectomy.

Results: Data of 14 767 patients from 12 European hospitals were analyzed. Overall, 6563 (44.4%) patients used at least one NPM; with distraction and cold packs being the most frequently used. The 8204 (55.6%) patients, who did not use NPMs had little yet significantly more pain relief than patients, who used them (means of 71.2% ± 27.9% versus 68.6% ± 25.7%, P < 0.001). Using NPMs does not affect the wish for more pain treatment. This is true for every single NPM. The only exceptional sub-group included total knee replacement patients, where a positive effect of NPMs was observed.

Conclusions: Some NPMs are widely used while others are rarely applied. Their association with pain relief is doubtful. These findings add to a rather contradictory literature. Advantages and disadvantages of applying NPMs solely for pain relief should thus be considered carefully.

Keywords: Non-Pharmacological Methods; Pain Relief; Patient-Reported Outcome Measures; Postoperative Pain; Wish for More Pain Treatment.