Guided Imagery Meditation Reduces Anxiety, Postoperative Pain After Cholecystectomy

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Researchers sought to determine the effects of guided imagery meditation on anxiety, quality of sleep, and postoperative pain in patients following laparoscopic cholecystectomy.

Guided imagery meditation reduced anxiety, improved sleep quality, and decreased postsurgical pain in patients who underwent laparoscopic cholecystectomy, according to study findings published in Pain Management Nursing.

Researchers conducted a randomized controlled trial (ClinicalTrials.gov Identifier: NCT04390828) involving a pre-test and post-test of 68 patients who underwent laparoscopic cholecystectomies in the general surgical ward of a teaching hospital in northeastern Taiwan. The researchers randomly assigned the patients to experimental (n=33) and control (n=33) groups. Two patients underwent an intraoperative change of surgery and were no longer included in the study.

On the day of surgery, patients in the experimental group received the guided imagery meditation once before and twice following surgery, while the control group received standard care. The guided imagery meditation session lasted between 15 to 20 minutes and consisted of meditation practice, guided images, music assistance, and 5 minutes of breathing relaxation training.

Prior to surgery, the patients completed a pre-test, including the Beck Anxiety Inventory and the Pittsburgh Quality of Sleep Inventory, which were translated into Chinese. They also rated their pain on a scale of 0 to 10 using the Numerical Rating Scale-11. They repeated these questionnaires as a post-test on day 2 after surgery and following the guided imagery meditation intervention.

Mean scores on the Beck Anxiety Inventory decreased from 6.0 on the pre-test to 0.42 on the post-test, while mean scores in the control group decreased from 8.55 to 4.79. Guided imagery meditation significantly reduced anxiety in the experimental group compared with the control group (P <.01).

Mean scores on the Pittsburgh Quality of Sleep Inventory decreased from 5.61 on the pre-test to 2.67 on the post-test, while mean scores in the control group increased from 7.06 to 7.55. Guided imagery meditation significantly improved quality of sleep in the experimental group compared with the control group (P <.001).

Patients in the experimental group reported less pain postoperatively than the control group (2.21 points vs 4.00 points; P <.001). The investigators did not observe any statistical difference between the 2 groups in terms of postoperative use of oral analgesics.

“The results of this study support that [guided imagery meditation] could effectively relieve postoperative pain, ease anxiety, and improve the quality of sleep in Taiwanese patients who underwent gallstone surgery,” the study authors said.

Study limitations included the single-center design, the lack of generalizability to patient populations outside of northeastern Taiwan, the lack of long-term follow-up after postoperative day 2, and statistical use of an analysis of covariance (ANCOVA), instead of the generalized estimating equation (GEE) method using the intention to treat (ITT) approach to reduce bias.

Reference

Lu YJ, Lee MC, Chen CY, Liang SY, Li YP, Chen HM. Effect of guided imagery meditation during laparoscopic cholecystectomy on reducing anxiety: A randomized controlled trial. Pain Manag Nurs. Published online July 31, 2022. doi:10.1016/j.pmn.2022.07.003