Efficacy of nonpharmacological therapies for postoperative pain in cardiac surgery: A systematic review

Abstract

Introduction: Postoperative pain is common and occurs frequently in patients undergoing cardiac surgery, which can lead to adverse events. Therefore, it is critical that assessment and adequate analgesia are performed to avoid compromising the recovery process. It is recommended that multimodal therapy be used for this purpose, as it promotes better analgesia. Therefore, the aim of this study is to search for studies that address the efficacy of nonpharmacological methods for pain relief in these patients. Methods: This study used a PRISMA-compliant systematic literature review that selected primary randomized clinical trials on the efficacy of nonpharmacological pain relief therapies in patients undergoing cardiac surgery. Searches were conducted in PubMed, LILACS, CINAHL, the Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials, with no time or language restrictions. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Clinical Trials was used to assess methodological rigor. Results: After screening, 23 of the 140 studies found in the databases were selected. The studies examined the efficacy of thirteen different nonpharmacological therapies, as well as a combination of therapies, with massage therapy being the most commonly examined, followed by musical intervention and hypnosis. Conclusions: Some interventions, when combined with pharmacological therapy, were effective in relieving postoperative pain after cardiac surgeries, according to the studies analyzed. However, most studies had significant methodological flaws, and further studies with high methodological quality are needed. Systematic review registration: The present study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42020168681.