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Guided Imagery Useful for Colorectal Surgery
What the Study Showed

Guided imagery has been used therapeutically for centuries to promote relaxation and ease patients through stressful events. The findings of a study done at the Cleveland Clinic Foundation in Ohio demonstrated conclusively that patients undergoing a specific type of gastrointestinal surgery can benefit significantly by using specially designed audio tapes devoted to this ancient healing technique.

The results were published in Diseases of the Colon and Rectum, the official journal of the American Society of Colon and Rectal Surgeons.

How It Was Done

Investigators enrolled 130 patients who were undergoing elective colorectal surgery for Crohn's disease, ulcerative colitis, cancer, or other GI ailments. The patients were randomly assigned to one of two groups; the composition of the groups was similar in age (mean age was 40), gender, and diagnosis.

Participants in the control group received no special treatment or advice in regard to handling pain or anxiety leading up to or following surgery. Participants in the treatment group were asked to listen to a guided imagery tape three days before the surgery and again during each of the first six days post-op. They were also given a special music-only tape to play during the operation and in the recovery room.

The guided imagery tapes for the study were designed to help calm the body, focus thoughts, and transport listeners to a place in their mind considered safe, protected, and relaxed. The imagery evoked by the narration helps listeners to work through feelings of anxiety, fear, and negativity; the music helps enhance and reinforce feelings of well-being.

Every day, participants in both groups were asked to rate their levels of anxiety and pain on a scale from 0 (no pain) to 100 (greatest pain ever). The researchers also recorded the amount of narcotic (pain drug) consumption, time to first bowel movement (often a key concern following abdominal surgery), length of hospital stay, and number of complications.

In the end researchers found that treatment group participants who listened to the tapes were more satisfied with their overall surgical experience. They reported significantly less pain and anxiety, and needed less powerful pain medication than did control group members.

Why It's Important

Previous studies have shown that guided imagery delivered via audio tapes can help a person better cope with stressful events, physiologically and psychologically. A well-designed tape with effective imagery can produce a state of focused concentration, which in turn fosters relaxation and a sense of emotional health. And the music reinforces these reactions. The goal of the audio material is to enable listeners to better control their reaction to a demanding event such as surgery.

The current study confirms that guided imagery combined with music can be an effective tool for handling surgery, specifically gastrointestinal surgery. This audio therapy is particularly useful because GI procedures often cause significant pain and the use of analgesics (painkillers) can further constipate a patient already anxious about that first bowel movement.

While the difference between the two groups was not significant in terms of post-operative complications or length of stay in the hospital, the guided imagery group did end up using significantly less narcotic medicine and had their first bowel movement earlier than the control group. The audio tapes were easy to use and relatively low-cost, yet made a big difference in the surgery experience for the participants assigned to use them.

Source: Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum 1997;40:172-178.

Date Published: 08/30/2003
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