RESEARCH FINDING USING GUIDED IMAGERY FOR
Preparing for Surgery

August, 2006

Scope and Cost of the Problem
In the year 2000, there were almost 40 million surgeries performed in U.S. hospitals (Hall & Owings, 2000). There were also 32.5 million in-office surgery procedures in 1998, many of which routinely use some sedation (M Hall & L Hall, 1998).


Mind-Body Approaches to Coping with Surgery
Patients are often given drugs (sedation) to reduce and calm them before surgery or other medical procedures. However, sedation often increases the risk of low blood pressure or getting too little oxygen. As a result, researchers have looked at other ways to reduce pre-surgical anxiety.

Some of the most effective techniques include relaxation with guided imagery, self-hypnosis, and providing reassuring information prior to the procedure (Ashton, Whitworth, et al, 2000; Dreher, 1998; Faymonville, Fissette, et al, 1995; Lang and Hamilton, 1994; Lang, Joyce, et al, 1996; Ludwick-Rosenthal, Neufeld, 1993).

Used before surgery, non-pharmacologigic, mind-body techniques can reduce anxiety in adults (Bennett, 1996; Bugbee, Wellisch, et al, 2005; Good, 2004; McCaffrey, Taylor, 2005; Pellino, Gordon, et al, 2005), and children (Calipel, Lucas-Polomeni, et al, 2005).

Relaxation with guided imagery or self-hypnosis before and during surgery can shorten procedures (Butler, Symons, et al, 2005; Halpin, Speir, et al, 2002; Lang, Benotsch, et al, 2000; Tusek, Church, et al, 1997). These techniques can also significantly reduce procedural and post-surgical pain and the need for pain medication (Antall & Kresevec, 2004; Ashton, Whitworth, et al, 2000; Faymonville, Fissette, et al, 1995; Good, Anderson, et al, 2005; Halpin, Speir, et al.; Huth, Broome & Good, 2004; Lambert, 1996; Lang, Benotsch, et al, 2000; Lang & Hamilton, 1994; Lang, Joyce, et al, 1996; Laurion & Fetzer, 2003; Manyande, Berg, et al, 1995; Meurisse, Hamoir, et al, 1999; Montgomery, Weltz, et al, 2002; Patterson, Wiechman, et al, 2006; Rensi, Peticca & Pescatore, 2000; Syrjala, Donaldson, et al, 1995; Tusek, Church, et al, 1997; Weinstein & Au, 1991), even when only used post-surgically (Nilsson, Rawal, et al, 2003).

These techniques can shorten the time it takes for patients’ intestinal motility to return to normal (Disbrow, Bennett & Owings, 1993; Tusek, Church, et al, 1997), and shorten their hospital stay (Bennett, 1996; Cowan, Buffington, et al, 2001; Disbrow, Bennett & Owings, 1993; Lambert, 1996; Meurisse, Faymonville, et al, 1996; Rapkin, Straubing & Holroyd, 1991; Tusek, Church, et al). There is also some evidence that these techniques can reduce blood loss (Bennett; Enqvist, von Konow & Bystedt, 1995; Lucas, 1975; Meurisse, Faymonville, et al), and speed wound healing (Holden-Lund, 1988; Ginandes, Brooks, et al, 2003; Jones, 1977).

Improvements have been shown in sleep (Gross,Kreitzer, et al, 2005), and other psychological parameters such anxiety (Ashton, Whitworth, et al, 2000; Gross, Kreitzer, et al; Kanji, White & Ernst, 2004), and post-surgical anger and depression (de Klerc, de Plessis, et al, 2004).

Several sources, including Blue Shield of California and Cedars Sinai Medical Center (Los Angeles), have reported that patients who used guided imagery tapes to prepare for surgery were very satisfied with them – plus, it reduced their bills (Fontana, 2000; Holden-Lund, 1988; Naiditch, 2000). In addition, guided imagery audio tapes are routinely used and recommended by many well respected physicians, including Mehmet Oz, M.D., heart surgeon and Director of the Complementary Care Center at New York’s Columbia Presbyterian Medical Center (Oz, 2000).


Conclusion
Research available to date supports the conclusion that a low-cost guided imagery-based program to prepare patients for surgery can help to lower pre-surgical anxiety, reduce pain and the need for post-operative medication, shorten procedure time and hospital stay, and possibly reduce surgical bleeding, and speed recovery.


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