Benefits of Post Operative Massage :)

Massage Therapy can be used in many settings.  In home patient care has become a fast growing industry to help aid in the recovery process.  Below is a study done on the benefits of post operative massage.  Enjoy! 

 

Using massage and music therapy to improve postoperative outcomes

AORN Journal,  Sept, 2003  by Laura D. McRee,  Stacie Noble,  Alice Pasvogel

 

Whether surgery is emergent or elective, the experience causes patient anxiety, which can be detrimental to surgical outcomes. (1) The anticipation of pain may cause increased anxiety, and, in turn, anxiety and pain cause an increase in levels of circulating catecholamines, adrenocorticotrophic hormone, growth hormone, prolactin, antidiuretic hormone, aldosterone, cortisol, glucagon, prostaglandins, and free fatty acids. (2) An increase in stress hormones and resulting metabolic responses can lead to a variety of morbid events, including myocardial and other organ ischemia, dysrhythmia, hypercoagulability, malnutrition, fluid and electrolyte imbalance, decreased wound healing, and immunocompromise. (2) Anxiety increases oxygen consumption, cardiac output, and blood pressure. (3) Furthermore, anxiety and stress can increase the need for higher doses of anesthetics and sedatives during surgical procedures, resulting in a potentially negative effect on a patient's recovery. (3) Fear of pain is a significant fear ranked second only to fear of death; (4) therefore, it is important for surgical teams to be aware of interventions that could decrease anxiety and pain.

This study was designed to determine whether massage and music therapy could decrease anxiety, resulting in positive outcomes related to cardiovascular hemostasis and decreased pain for patients. A variety of studies related to the effects of massage or music therapy on patients' anxiety have been conducted.

MASSAGE THERAPY. Massage is the art of touch and manipulation of soft tissue to achieve therapeutic results, including mental relaxation, comfort, and healing. (5) Massage has been considered a therapeutic intervention for thousands of years. There is evidence of the use and value of therapeutic massage in China more than 5,000 years ago. (6) A person's tactile needs do not change with health or aging; however, patients who are acutely ill or undergoing surgery seldom are touched other than when they are receiving necessary care. (5) Caring touch, compared to technical or mechanical touch, is an important method of communication. (7)

There are a number of theories about the mechanisms for massage's therapeutic effects on psychological and physical status. Most simply, massage nay relieve pain through muscle relaxation and the release of enkephalins. (6,8)

The gate control theory of pain also has been used to explain the effectiveness of massage in pain control. (6) According to this theory, tactile information from massage is carried on the large myelinated fibers, which may close the neurological "pain gate" at the peripheral point, thus reducing the perception of pain.

Two other mechanisms for pain relief through massage have been identified:

* soft tissue manipulation improves circulation, which reduces pain caused by the accumulation of irritants, including lactic acid and inflammatory substances; and

* the emotional contact of caring touch may induce a sense of well-being that would diminish the perception of pain. (9)

Results of previous studies have demonstrated therapeutic benefits of massage in a variety of circumstances, especially in terms of decreased anxiety, decreased stress response, and less pain. In a study of the effects of massage on 122 patients admitted to an intensive care unit (ICU), participants were assigned randomly to receive massage, aromatherapy and massage, or a period of rest. (10) Preintervention and postintervention assessments included physiological stress indicators and patients' evaluations of their anxiety level, mood, and ability to cope with the intensive care experience. No significant differences were reported in the physiological stress indicators, which included systolic and diastolic blood pressure, heart rate and rhythm, and respiratory rate. The group that received massage and aromatherapy, however, demonstrated significant improvements in mood and reported decreased anxiety after therapy.

One study evaluated the effects of massage on anxiety among older adult, institutionalized patients. (11) Participants were assigned randomly to a group that received a five-minute back massage and engaged in conversation with the massage therapist, a group that participated in a five-minute conversation only, or a group that received no interventions. Anxiety was measured using the Spielberger State-Trait Anxiety Inventory (STAI) before and after interventions and at two points in time for the group that received no interventions. The study was conducted during four consecutive days. Mean anxiety scores indicated that anxiety levels were significantly lower for the group that received massage compared to the group that received no interventions.

One group of researchers studied the effects of massage on 28 patients in a hospital burn unit. (12) Patients were assigned randomly to a massage therapy group or a standard treatment control group before undergoing a debridement procedure. The group that received massage demonstrated less anxiety, lower cortisol levels, less pain, and less depression than the group that received standard care. A limitation of this study is the lack of a comparison intervention; therefore, it cannot be determined whether an intervention other than massage would have produced the same effects.

One researcher studied the effects of therapeutic massage on preoperative anxiety, gathering both quantitative and qualitative data. (13,14) Sixty patients undergoing general surgical or gynecological procedures were selected from a rural hospital. The treatment group included 30 patients who received 45 minutes of preoperative massage. The control group did not receive any interventions. Measures included anxiety as indicated by scores on the STAI, the amount of analgesia required, and length of hospital stay. In addition, study participants were interviewed during their massages to elicit their perceptions of the experience. The results demonstrated that the group that received massage experienced reduced preoperative anxiety compared to the control group; however, there were no significant differences in amounts of analgesia used or length of stay between the two groups. Analysis of participant interviews revealed that those who received massage believed their vulnerability was respected and that the massage provided an environment in which they felt safe to talk. A limitation of this study is, again, lack of a comparison intervention.

MUSIC THERAPY. Music has been defined as the science or art of the composition of sounds that are comprehended by the human brain as enjoyable and expressive. (3) In the 1800s, music was used to aid sleep, decrease anxiety associated with surgery, and assist in the administration of local anesthesia. (2) The physiological effects of music have been measured using blood pressure, mean arterial pressure, heart rate, electrocardiogram, respiratory rate, oxygen saturation, finger temperatures, and serum hormone levels. (15)

Many studies have examined the effect of music on patients' anxiety. One study examined the effects of music use in various medical specialties, including anesthesiology, surgery, orthopedics, dentistry, and obstetrics. Patients selected the music they preferred and listened to it during the preoperative wait. Headphones were left on until patients were asleep. Patients who received local anesthesia wore headphones during the entire procedure. Findings included decreased levels of anxiety, decreased blood pressure, and decreased hormone levels, including prolactin, cortisol, adrenocorticotrophic hormone, growth hormone, and norepinephrine. (16)

A pilot study of 30 patients scheduled for elective orthopedic surgical procedures performed using regional anesthesia was conducted to determine whether having patients listen to their favorite music while undergoing the surgical procedure reduced their anxiety. (3) Data were collected using questionnaires designed to obtain feedback about patients' selections and their feelings about listening to music during surgical procedures. Patients reported that music helped the surgery go more quickly, masked background noises, and diverted their minds from the procedure. Perioperative staff members provided positive feedback about the use of music, and anesthesia care providers noted that participants were calmer throughout the procedures, pulse and blood pressures remained more stable, and less anesthesia was required.

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