Effect of Relaxation Exercises on Controlling Postoperative Pain

This study examines the effect of relaxation exercises on controlling postoperative pain in patients who have undergone upper abdominal surgery. This is a cross-sectional and crossover study conducted on 60 patients who underwent upper abdominal surgery between October 2006 and June 2007, in the General Surgery Department, Health and Research Practice Center, Trakya University, Edirne, Turkey. They assessed the patients’ pain levels before and after the relaxation exercises.

Relaxation exercises, a nonpharmacologic method, are effective in reducing postoperative pain and should therefore be included in a regimen to control postoperative pain in patients who have undergone upper abdominal surgery.

Introduction

Upper abdominal surgery is a painful surgical procedure. Inadequate pain control in these patients can lead to many complications, reduction of participation in treatment and care, patient dissatisfaction, longer hospitalization, and increased costs As a nonpharmacologic method, relaxation exercise helps to reduce postoperative pain and anxiety and thereby prevent complications. The use of relaxation exercises in the postoperative period will increase patient satisfaction with nursing care as well as providing effective pain control.

Discussion

This study examined the effect of relaxation exercises on pain levels of 60 patients undergoing upper abdominal surgery. Postoperative pain levels were found to be markedly reduced with the use of relaxation exercises. Similarly, Good et al., 2001a, Good et al., 2005 and Roykulcharoen and Good (2004), in their studies of patients undergoing abdominal surgery, demonstrated that relaxation exercises effectively reduced postoperative pain. Aslan (1998) also showed that relaxation exercises effectively controlled postoperative pain in patients undergoing upper abdominal surgery.

Similar results have been found in different surgical procedures. In their study of patients undergoing gynecologic surgeries, Good et al. (2002) found that relaxation exercises were effective in reducing the pain experienced due to various factors on the first and second postoperative days. In a further study, Good et al. (2006) supported the use of relaxation exercises, as a method supplementary to analgesics, in reducing postoperative pain. Friesner et al. (2006) demonstrated that relaxation exercises positively affected patients whose pain levels were assessed immediately after the removal of the chest tube and 15 minutes later.

The results of the present study, as well as the results of the earlier studies, show that relaxation exercises play an effective role in pain control after surgery, not only in the upper abdominal area but also in other parts of the body. There was no correlation between pain levels and individual characteristics, surgical procedure, or chronic disease in the present study. Good et al. (2001a), and Roykulcharoen and Good (2004) also reported no statistically significant correlation between patients’ age, gender, or educational status and their pain levels before and after relaxation exercises. The results of our study support the findings of those other studies.

It was statistically significant that, even before the relaxation exercises, the pain was reduced with each passing postoperative day. Good et al. demonstrated in several studies that patients undergoing abdominal surgery and not using any nonpharmacologic pain control method experienced less pain in the second postoperative day than during the first postoperative day (Good et al., 1999, Good et al., 2001a, Good et al., 2005). Research done by Pellino (2005) on patients who had undergone total hip and knee arthroplasty found that pain levels were reduced with each postoperative day, both in the cases under study and in the control group. As a result, it is apparent that postoperative pain reduces with each postoperative day in parallel with tissue recovery.

Limitations


In the present study, pain was assessed on the first to fourth postoperative day. Postoperative pain decreases in accordance with the healing process, and the duration of pain observed after upper abdominal surgery is 4 days (Aslan, 2006). Therefore, postoperative pain levels were assessed on these days after surgery. Other limitations are that relaxation exercises were taught and applied after analgesic application to facilitate learning and practice by patients. Limited sample size due to the study’s being conducted in a regional hospital was also a limiting factor.

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