Key result
Perioperative behavioral interventions reduce postsurgical pain and opioid use for up to 12 months.
Why the study?
Existing meta-analyses of perioperative behavioral interventions for postsurgical pain relief are limited by non-surgical populations or short-term outcomes, lacking a scoping review of efficacy in the days and months after surgery.
Do perioperative skills-based behavioral interventions improve postsurgical pain relief and reduce opioid use in surgical patients?
Do perioperative skills-based behavioral interventions improve postsurgical pain relief and reduce opioid use in surgical patients?
Perioperative behavioral interventions show some durable analgesic effects and opioid reduction, but evidence is limited by a lack of active controls and studies on chronic pain prevention.
May support short-term analgesia and opioid reduction; leaves open durable effects and chronic pain prevention without active controls.
Perioperative skills-based interventions may support non-pharmacological management of pain and opioid reduction after surgery. Such interventions may target and enhance predictors for surgical recovery and possibly reduce chronic postsurgical pain. Existing meta-analyses are limited by inclusion of studies that are either non-surgical or with outcomes occurring only in the hours after surgery. Lacking is a scoping review of studies testing perioperative skills-based interventions for postsurgical pain relief and opioid reduction in the days and months after surgery. We reviewed the efficacy of perioperative behavioral interventions; over what time frame and in which surgical populations efficacy evidence exists; and whether such interventions can prevent chronic postsurgical pain. 20 randomized trials were included, with the following intervention types: hypnosis, relaxation therapy, stress management training, mindfulness, mixed-type skills interventions (mind-body skills, preoperative pain self-management, empowered relief for surgery); cognitive behavioral-therapy (CBT); and mindfulness-based CBT. We summarize study methods, treatment specifics, and analgesic effects. No studies were designed to test intervention efficacy for preventing chronic postsurgical pain. Only two studies used active controls as the study comparator. Two studies showed positive effects on postsurgical opioid use. No studies tested whether the interventions enhanced time to pain cessation after surgery. Four studies demonstrated durable analgesic effects at 3-12 months after surgery. We describe the real-world practicality of intervention integration into the perioperative pathway and provide dissemination and implementation methodologies that may increase intervention uptake and therefore fulfill calls from national agencies to better integrate behavioral pain treatments into perioperative care.
No takes yet. Share an insight, caveat, or question.
Darnall et al. (2025) conducted a review in Perioperative pain and opioid use. Perioperative behavioral interventions vs. Usual care or active control was evaluated. Perioperative behavioral interventions demonstrated short- to moderate-term analgesic efficacy and reduced opioid use in several trials, with four studies showing durable analgesic effects up to 12 months after surgery.