In this pilot study, researchers from the University of Montreal investigated the impact of a guided imagery intervention on post-op pain intensity, anxiety, coping and daily activities in adolescents and young adults, ages 11-20, after undergoing orthopedic surgery (spinal fusion) for idiopathic scoliosis.

Participants were randomized to standard care or standard care with the guided imagery intervention. The intervention 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 pre-operatively and at discharge (T1) and telephoned 2 weeks post-discharge (T2) to reinforce the use of 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.

Forty participants were enrolled of 45 eligible participants, 20 per group, with the average age being 15 ± 2.1 years, and 7 participants being male.
Compared with the control group, the experimental group experienced significantly less overall pain at all three 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 investigators conclude 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 that a larger sample size and longer (6-9 months) follow-up would permit refinement.

Citation: Sylvie Charette, RN, MSN, Jacinthe Lachance Fiola, PhD, , Marie-Claude Charest, MPs, Edith Villeneuve, MD, , Jean Théroux, DC, MSc, Julie Joncas, RN, BSc, §, Stefan Parent, MD, PhD, §, , Sylvie Le May, RN, PhD. Guided Imagery for Adolescent Post-spinal Fusion Pain Management: A Pilot Study. Pain Management Nursing. 2014 Nov 6. pii: S1524-9042 (14) 00105-2. sylvie.lemay@umontreal.ca.