Psychological interventions, including cognitive behavioral therapies and relaxation techniques, improved surgical outcomes by positively modulating the metabolic surgical stress response and reducing perioperative pain and anxiety.
Systematic Review
Do psychological interventions improve pain, anxiety, and metabolic stress responses in patients undergoing surgery?
Psychological interventions such as relaxation and mindfulness may improve perioperative outcomes by positively modulating the neuroendocrine and metabolic surgical stress response.
BACKGROUND: An amplified and/or prolonged surgical stress response might overcome the organs' functional reserve, thus leading to postoperative complications. The aim of this systematic literature review is to underline how specific psychological interventions may contribute to improve surgical outcomes through the positive modulation of the surgical stress response in surgical patients. METHODS: We conducted a comprehensive literature search in the Cochrane Register of Controlled Trials, PubMed, EMBASE, Scopus, PsycINFO, and CINAHL databases. Only studies published in English from Jan 2000 to Apr 2022 and reporting pain and/or anxiety among outcome measures were included in the review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioral therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis, and (6) coping strategies. RESULTS: Among 3167 records identified in the literature, 5 papers were considered eligible for inclusion in this review because reporting the effects that psychological features have on neurochemical signaling during perioperative metabolic adaptation and those metabolic and clinical effects that the psychological interventions had on the observed population. CONCLUSION: Our findings confirm that psychological interventions may contribute to improve surgical outcomes via the positive influence on patients' metabolic surgical stress response. A multidisciplinary approach integrating physical and non-physical therapies can be considered a good strategy to successfully improve surgical outcomes in the perioperative period.
Lanini et al. (Sat,) conducted a systematic review in Patients undergoing elective or emergency surgery. Psychological interventions (relaxation techniques, cognitive-behavioral therapies, mindfulness, narrative medicine, hypnosis, coping strategies) vs. Standard care or control was evaluated on Pain and/or anxiety and metabolic surgical stress response. Psychological interventions, including cognitive behavioral therapies and relaxation techniques, improved surgical outcomes by positively modulating the metabolic surgical stress response and reducing perioperative pain and anxiety.