The effectiveness of a preoperative multi-component non-pharmacologic preparation on post-tonsillectomy pain: A randomized controlled clinical trial

Technology-Based Interventions for Pain in Children Undergoing Surgery: A Systematic Review and Meta-Analysis

AIM

This systematic review and meta-analysis aimed to evaluate the effect of technology-based interventions on the pain of paediatric surgery patients.

BACKGROUND

Recently, the number of technology-based interventions involving multimodal nonpharmacological methods tailored to pain management in paediatric surgery patients has increased. It is crucial to determine the effectiveness of these interventions.

DESIGN

A systematic review and meta-analysis of randomized controlled trials following Cochrane methods was conducted.

REVIEW METHODS

We performed a literature search in the Web of Science, PubMed, CINAHL, Science Direct, MEDLINE, ProQuest and Cochrane Library databases. Two independent researchers screened the literature using specific keywords and selected randomized controlled trials based on the inclusion and exclusion criteria. Each researcher extracted data and assessed the risk of bias in the randomized controlled trials using the Cochrane bias risk assessment tool.

RESULT

We conducted a meta-analysis on 14 randomized controlled trials included in the study. The results showed that technology-based interventions reduced pain scores in paediatric surgery patients. Cochran's Q test results pointed to a high level of heterogeneity among the randomized controlled trials.

CONCLUSION

A meta-analysis result of 14 randomized controlled trials showed that technology-based interventions are effective methods for reducing pain in paediatric surgery patients.

REGISTRATION NUMBER

CRD42021226666.

A Systematic Review of the Effectiveness of Non-Pharmacological Therapies Used by Nurses in Children Undergoing Surgery

OBJECTIVE

The aim of this study was to identify non-pharmacological pain relief therapies in children undergoing surgery.

DESIGN AND DATA SOURCES

Using keywords extracted from Medical Subject Headings and "Descriptores en Ciencias de la Salud" we searched for articles in the Web of Science, Scopus, Cuiden, PubMed, and CINHAL databases from the last five years, and performed a reverse search. We assessed the documentary quality of the articles using various standardized instruments.

RESULTS

The final review included eleven studies. In terms of cognitive-behavioral techniques, there is evidence that both music and video therapy are effective in reducing postoperative pain in children in seven studies, and therapeutic play in five studies. Other methods used less frequently but found to be effective included laughter therapy in one study and deep breathing in another. Regarding physical methods of pain relief, massage was found to be an effective non-pharmacological therapy for reducing pediatric postoperative pain in two studies and ineffective in another.

CONCLUSIONS

In this study, we highlight the importance of non-pharmacological therapies in pediatric postoperative pain management. Cognitive-behavioral techniques, especially music therapy, video therapy, and therapeutic play, reduce pediatric postoperative pain. They are therefore effective therapies that nurses can use in this area. Further research into the effectiveness of storytelling is necessary, as the evidence is not entirely conclusive. More evidence is also needed on physical methods of pain relief, particularly massage.

Innovative Program to Prevent Pediatric Chronic Postsurgical Pain: Patient Partner Feedback on Intervention Development

BACKGROUND

The risk of developing chronic postsurgical pain (CPSP) in youth is related to psychological factors, including preoperative anxiety, depression, patient/caregiver pain catastrophizing, and poor self-efficacy in managing pain. While interventions exist to address these factors, they are generally brief and educational in nature. The current paper details patient partner feedback on the development of a psychologist-delivered perioperative psychological program (PPP) designed to identify and target psychological risk factors for CPSP and improve self-efficacy in managing pain.

METHODS

Qualitative interviews were conducted with two patients and their caregivers to discuss their surgical and pain management experience and to advise on components of the PPP.

RESULTS

Reflexive thematic analysis of interviews generated the following themes, which were incorporated into the content and implementation of the PPP: caregiver involvement, psychological and physical strategies for pain management, biopsychosocial pain education, intervention structure, and supporting materials.

CONCLUSIONS

The development of a novel psychologist-led PPP is a promising approach to mitigate mental health risks associated with pediatric CPSP and potentially boost postoperative outcomes and family wellbeing. Integrating patient partner feedback ensures that the PPP is relevant, acceptable, and aligned with the needs and preferences of the patients it is designed to serve.