To be mindful of the breath or pain: Comparing two brief preoperative mindfulness techniques for total joint arthroplasty patients.
Study Goal
The researchers aimed to compare the effectiveness of two mindfulness-based interventions (mindfulness of breath and mindfulness of pain) versus cognitive-behavioral pain psychoeducation in reducing preoperative and postoperative pain and opioid use in TJA patients.
Results Summary
Mindfulness of breath (MoB) was most effective in reducing preoperative pain, while mindfulness of pain (MoP) resulted in the least postoperative pain intensity and interference. Both MoB and MoP reduced postoperative opioid use compared to cognitive-behavioral intervention.
Population
Patients undergoing total joint arthroplasty (TJA) of the knee or hip (N = 118, mean age = 65, 73 female, 110 Caucasian).
Effective Dosage
Single 20-minute session delivered during a 2-hour preoperative education program.
Duration
Approximately 3 weeks before surgery (single session).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness of breath (MoB) | decrease | preoperative pain scores | patients undergoing TJA of the knee or hip | - | most effectively decrease | #1 |
mindfulness of pain (MoP) | decrease | postoperative pain intensity | patients undergoing TJA of the knee or hip | - | resulted in the least amount of | #2 |
mindfulness of pain (MoP) | decrease | postoperative pain interference | patients undergoing TJA of the knee or hip | - | resulted in the least amount of | #3 |
mindfulness of breath (MoB) | decrease | postoperative opioid use | patients undergoing TJA of the knee or hip | - | decreased | #4 |
mindfulness of pain (MoP) | decrease | postoperative opioid use | patients undergoing TJA of the knee or hip | - | decreased | #5 |
OBJECTIVE: Total joint arthroplasty (TJA) often reduces pain and improves function, but it is also a risk factor for the development of chronic pain and postoperative opioid use. To protect against these untoward postsurgical outcomes, TJA patients need better, non-pharmacological pain management strategies. This study compared two, promising, mindfulness-based pain management techniques. METHOD: We conducted a single-site, three-arm, parallel-group randomized controlled study conducted at an orthopedic clinic among patients undergoing TJA of the knee or hip. TJA patients (N = 118, M age = 65, female = 73, Caucasian = 110) were randomized to either a preoperative mindfulness of breath (MoB), mindfulness of pain (MoP), or cognitive-behavioral pain psychoeducation (CB) intervention, approximately 3 weeks before surgery. Each intervention was delivered in a single, 20-min session during a 2-hr, preoperative education program. Change in pain intensity was the sole preoperative outcome. The postoperative outcomes, pain intensity, pain interference, and opioid use were assessed on the 2nd, 3rd, 7th, 14th, 21st, and 28th postoperative days. RESULTS: MoB was found to most effectively decrease preoperative pain scores, F(2, 89) = 5.28, p = .007, while MoP resulted in the least amount of postoperative pain intensity, F(8, 94) = 3.21, p = .003, and interference, F(8, 94) = 2.52, p = .016). Both MoB and MoP decreased postoperative opioid use relative to CB, F(8, 83) = 16.66, p < .001. CONCLUSION: A brief preoperative MBI may be able to prevent both postoperative pain and opioid use. Moreover, the MBIs used in this study are highly feasible, capable of being delivered by nearly any healthcare provider, and requiring minimal clinic time given their brevity. As such, embedding MBIs in surgical care pathways has considerable potential. (PsycInfo Database Record (c) 2021 APA, all rights reserved).