Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial

Abstract

BackgroundCardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind–body interventions are an area of growing interest. Preoperative mind–body interventions such as Isha Kriya meditation, may hold significant potential to improve postsurgical outcomes.MethodsThis is a prospective, randomized controlled feasibility trial. A total of 40 adult patients undergoing cardiac surgery will be randomized to one of three study groups. Participants randomized to either of the two intervention groups will receive meditative intervention: (1) commencing two weeks before surgery; or (2) commencing only from the day after surgery. Meditative intervention will last for four weeks after the surgery in these groups. Participants in the third control group will receive the current standard of care with no meditative intervention. All participants will undergo assessments using neurocognitive, sleep, depression, anxiety, and pain questionnaires at various time points in the perioperative period. Blood samples will be collected at baseline, preoperatively, and postoperatively to assess for inflammatory biomarkers. The primary aim of this trial is to assess the feasibility of implementing a perioperative meditative intervention program. Other objectives include studying the effect of meditation on postoperative pain, sleep, psychological wellbeing, cognitive function, and delirium. These will be used to calculate effect size to design future studies.DiscussionThis study serves as the first step towards understanding the feasibility of implementing a mind–body intervention as a prehabilitative intervention to improve postoperative surgical outcomes after cardiac surgery.Trial registrationClinicaltrials.gov, NCT03198039. Registered on 23 June 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3103-8) contains supplementary material, which is available to authorized users.

Relationship between emotional states before cardiac valve surgeries with postoperative complications

“…Nonetheless, in addition to recognizing anxiety and depression symptoms, nurses are supposed to intervene whenever these symptoms are identified (26) . Surgical pre-rehabilitation is an emergent concept that refers to interventions implemented in the preoperative period in order to improve postsurgical results (27) . This includes preventive strategies like physical therapy, and pharmacological and non-pharmacological measures to improve results (27) .…”

Is Chest Compression Superimposed with Sustained Inflation during Cardiopulmonary Resuscitation an Alternative to 3:1 Compression to Ventilation Ratio in Newborn Infants?

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“…For flexible and tailored management, these programmes include (separately or together) personal visits, community services, or home manuals with phone or electronic support. Nursecoordinated care, case management, telemonitoring with periodic follow-up, and community-based groups with ongoing health practitioner assistance given in a variety of locations are also other options to consider [2].…”