In this pilot study, researchers from the University of Montreal in Quebec, Canada, investigated the efficacy of guided imagery for pain management with adolescents, ages 11-20 years, after undergoing spinal fusion surgery for scoliosis, a medical procedure that entails considerable anxiety and postoperative pain.

Participants were randomized to standard care or standard care with the guided imagery intervention, which consisted of a DVD with information and guided imagery/relaxation exercises to practice at least three times a week at home.

A nurse screened the DVD with the patient preoperatively and at discharge (T1) and telephoned 2 weeks post-discharge (T2) to reinforce the technique. Both groups completed questionnaires at T1, T2, and T3 (1-month postoperative follow-up).

Outcome measures included pain intensity, anxiety, coping mechanisms, and daily activities.

From March 2010 to June 2011, 40 of 45 eligible participants were enrolled (n = 20 per group) , average age 15 ± 2.1 years. Seven participants were male.

Compared with the control group, the experimental group experienced significantly less overall pain at all time points, with moderate to large effect sizes at T2, T3 (p ≤ .007).

Worst pain in 24 hours was moderately decreased at T2 (p = .01). State-trait anxiety remained high. On a 10-point scale, a median 2.5-point benefit was seen in eating and sleeping (Mann-Whitney test, p = .002), and 2 points in walking (Mann-Whitney test, p = .003).

Coping strategies showed no significant differences.

The pilot study concluded that the addition of a guided imagery and relaxation exercise DVD for home use was more effective than standard care alone for postoperative pain, and recommends a larger sample size and more extended follow up data (6-9 months) in future studies.

Citation: Charette S, Fiola JL, Charest MC, Villeneuve E, Théroux J, Joncas J, Parent S, Le May S. Guided Imagery for Adolescent Post-spinal Fusion Pain Management: A Pilot Study. Pain Management Nursing. 2014 Nov 6. pii: S1524-9042(14)00105-2. [email protected]