Relaxation Before, During, & After Surgery
A perusal of medical literature since 1960 indicates that over 150 valid scientific studies have been published to date about the impact of relaxation techniques on the body and soul of surgery patients before and during the surgery, as well as during convalescence. The research methods are similar in most of the studies: Several days before the surgery, the study subjects in the experimental group are instructed in various relaxation techniques. They are asked to practice the relaxation techniques daily on their own or by listening to a relaxation recording. During the surgery, they are counseled to ask the anesthesiologist to allow them to listen to a relaxation session on a cassette, CD or IPod. They are asked to continue practicing relaxation techniques during convalescence. The studies were conducted on a very wide variety of surgeries, such as heart, cancer, gastrointestinal diseases, and orthopedics.
The experimental group shows the following positive changes as compared with the control group:
Before the Surgery: Lower anxiety and depression levels, fewer intrusive thoughts and restful sleep.
During the Surgery: Lower doses of anesthesia and shortened surgery duration.
During Convalescence: Lower anxiety and depression, fewer intrusive thoughts, restful sleep, faster healing of the area of surgery, less pain medication, lower incidence of fever and infection, less antibiotics, quicker restoration of the digestive and urinary system, and earlier release from the hospital.
The explanation for the positive effect of relaxation upon surgery is very simple: When the patient is relaxed, the amount of stress hormones in his bloodstream is very low. As a result, his sleep is restful and his muscles are relaxed. The relaxed muscles lower the pain and enables more blood and immunity building substances to flow into the affected area, thus speeding up the healing and preventing infections.
It is interesting to note that in spite of the abundance of medical studies proving the positive effect of relaxation upon the surgery process, the public at large is not aware of it and very few people use this method. In my opinion, most of the surgeons are not aware of the tremendous advantage of implementing these methods, which is regrettable.
Implementing Relaxation Techniques Before A Surgery: It is advisable for the patient to practice various relaxation techniques from the day he feels increased stress and anxiety related to his physical condition. Based on my experience, the more often a person practices
the relaxation techniques, the more calm his body and soul. It is advisable for patients to listen to a relaxation recording before going to sleep and to fall asleep listening to it. It is a good idea to practice various relaxation techniques even while waiting for the surgery.
Studies found that it is extremely important to practice mental imagery technique several times a day. Each practice takes only a few minutes. It is best for patients to start with a few deep breaths (please read chapter
Deep Breathing).
If a negative thought or picture interfere, it is very important to replace it with a positive one. The patient should treat the negative thought or picture as if it were a television channel that can be switched to a more agreeable one.
Implementing Relaxation Techniques During Surgery: Studies show that even during surgeries under general anesthesia a certain percentage of patients are still able to hear the voices of the surgeon and nurses. Since the patient is under the influence of an anesthetic, he may distort the meaning of the voices and attribute to them negative meanings like, for example, the surgery was not successful or a mistake has been made. It is recommended that the patient meet the surgeon and the anesthesiologist before the surgery and ask them to
transmit positive messages to him during the surgery even if he seems to be totally under the influence of the anesthesia. The surgeon and the
anesthesiologists should be asked to report out loud what is going on and how happy they are with the progress of the surgery. The patient may
ask the surgeon's and anesthesiologist's permission for him to listen to relaxation recording with earphones during the surgery and for
someone to activate the relaxation recording after he falls asleep. If the recording ends before the surgery is over, it should be activated
again.
Implementing Relaxation Techniques During Convalescence: It is very important for the patient to continue practicing the various relaxation methods during convalescence, both at the hospital and at home. Mental imagery technique allows him to imagine that the surgery has been a complete success. If in reality the patient feels pain while walking or bending, he should imagine himself performing these activities with great ease. If a negative thought or picture interfere, it is very important to replace it with a positive one. The patient should treat the negative thought or picture as if it were a television channel that can be switched to a more agreeable one. If the patient feels pain in the operated area, he must view it as a Healing Pain. There are two opposing methods for the patient to deal with a Healing Pain. One method is to use mental imagery that distracts thoughts. For example, the patient sees himself spending time in a calm, safe, and pleasant place. The patient may choose a place where he has been in the past and experienced these comfortable feelings, or an imaginary place he would like to visit. An opposite method is to focus on the painful area and imagine that the pain is decreasing and disappearing. There are people who imagine the painful area as being of a different color than the surrounding areas. They find it possible to gradually change a color that indicates pain into a color that indicates comfort. They also can imagine pain medication penetrating into the painful area and eliminating the pain.
The following are six studies about the effect of relaxation on surgery. Clicking on the title, opens the Abstract. Writing in google: "guided
imagery and relaxation for surgery" shows hundreds of articles about the topic.
A brief relaxation intervention reduces stress and improves surgical wound healing response: a randomised trial.
Broadbent E 1,
Kahokehr A,
Booth RJ,
Thomas J,
Windsor JA,
Buchanan CM,
Wheeler BR,
Sammour T,
Hill AG.
Brain Behav Immun.
2012 Feb;26
The
effects of hypnosis/guided imagery on the postoperative course of children.
SA Lambert - Journal of Developmental & Behavioral Pediatrics, 1996
Suggestion, relaxation, and hypnosis as adjuncts in the care of surgery patients: a review of the literature
RP Blankfield - American Journal of Clinical Hypnosis, 1991 - Taylor & Francis
Relaxation
strategies for patients during dermatologic surgery.
Shenefelt PD. J Drugs Dermatol. 2010 Jul;9(7):795-9
Effects of relaxation with guided imagery on surgical stress and wound healing.
Holden-Lund C. Res Nurs Health 1988 Aug;11(4):235-44
Anxiety,
relaxation and anesthesia for day-case surgery.
Markland D, Hardy L. Br J Clin Psychol 1993 Nov;32 ( Pt 4):493-504
Below are emails I received from people who underwent surgery:
Dear Dr. Elitzur:
It was my lucky day when I heard you speak at an Israeli club in New York. This took place approximately five weeks prior to a scheduled
knee replacement surgery due to severe arthritis. I have been anticipating this surgery with fear and stress, not to mention great pain over my entire body, for over a year. In order to avoid surgery, I tried all possible medications, alternative and otherwise, to no avail. When I heard you and came home with your Relaxation CD, I decided to give it a try. To my amazement the very next day all the other pains in my body subsided and the knee pain became isolated. As I listened to the CD over and over again, each night up till the scheduled date, I became calmer, happier and, in fact, I couldn't wait for the surgery. On the day of the operation, I was calm, relaxed and feeling very hopeful and happy. Among other things, I realized then that I was taking positive steps toward better health and a quality of life, which eluded me for at least the past two years. Due to the, Relaxation CD, I was also able to envision myself as an attractive, healthy woman who can walk like everyone else. My recovery and progress amazed all of my doctors and my family. When other patients were barely able to get out of their rooms, I was able to walk around the hospital corridors twice. When I had pain, and sometimes I still do, I know that it is the pain of
healing. One more significant thing is that one month after the surgery I stopped taking any medication whatsoever, including plain aspirin.
The exercises in the tapes seem to help even when I fall asleep at the beginning. These is an astonishing CD which definitely helped me, and
continue to help me to achieve my goal which is to walk and run, bike ride and dance like everyone else. I thank you from the bottom of my
heart and I hope that many more people will benefit from your remarkable work.
Naomi J
Dear Dr. Baruch Elitzur:
I would like to thank you from the bottom of my heart for your relaxation CD. Recently I had to undergo a stomach surgery and I got a recommendation to listen to the CD before the surgery, which I did. When it was my turn to go in for the surgery in the morning, the nurse told me that the surgeon had to operate on another woman first. I was surprised, but understood that God was helping me here because I wanted to listen to your wonderful relaxation CD in the disc player I had brought with me. When they came to prepare me for the surgery, I had tears in my eyes; not because of fear or pressure. On the contrary, I felt great excitement and joy. I remember, when I woke up from my general anesthesia, I had a big smile on my face. The nurse asked me whether I was okay and I remember telling her that I was feeling great. After the surgery, I listened to the relaxation CD again several times. I decided to internalize the methods from the CD. Each time I experienced pain from the surgery, for example, when I got up, when I sat down, when I walked, or for no particular reason, I brought into my thoughts and imagination the words you are saying on the CD and as a result I did not feel any pain. It worked like magic! I sincerely thank you.
Dear Dr. Baruch Elitzur:
My name is Mike, and I live in a small town north of Boston. About a week ago, I felt that one of my worse nightmares would become true. I
had to undergo a surgery to remove my gall bladder due to a severe gall bladder stone attack. The surgery would be performed with a general
anesthesia. I became so fearful that I could not stop thinking about it day and night. I could not sleep at night, and I could not function at work or at home. I work as a manufacturing manager, I have people reporting to me and they all noticed that I changed. They tried helping me out with advice from their personal experience but I could not even listen. Every time when I had to fill up the paperwork for the surgery, I started crying almost immediately. At that point, I realized that without help it will turn ugly, I will probably escape from the hospital or cancel the surgery. And if I would do it, I would have to deal with the physical consequences I mean, I would die. At that point, I discovered your website, with the evolutionary explanations of stress, the relaxing techniques and the audio recording of relaxation. It was my only chance, I had nothing to loose. I started crying as soon as I heard your voice from your website, but I noticed the relief after that. I was listening and practicing the techniques again and again days and nights. A day before the surgery I took my computer to a beautiful place that I used to enjoy and I listened to your voice again and again. The miracle happened that night, I gained full control over my body and mind, I felt ready for the operation! I went to the hospital the next day. During the entire operation, I heard your voice in my head and I felt that you spoke directly to me. Dr. Elitzur, I felt as if you were in the surgery room as a member of the surgery team. When I awoke, I felt very calm. My Dr. told me that the operation was very successful. Please, be sure to tell others of my experience and I hope it will help others who are in the same or similar situations.
Thank You!
Mike