Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study

Vagnoli, Laura; Bettini, Alessandra; Amore, Elena; Masi, Salvatore; Messeri, Andrea

doi:10.1007/s00431-019-03376-x

Cited by 76 publications

(60 citation statements)

References 54 publications

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“…Based on previous findings that massage, including the ones applied on foot, can facilitate endogenous OT release (Morhenn et al, 2012;Li et al, 2019), our current pilot findings that imagined massage evoked similar responses to real massage suggest that it may be a potential future therapeutic strategy for inducing changes in neural systems responding to social touch and evoking associated OT release. Furthermore, hypnosis can facilitate sensory imagery perhaps by reducing inhibitory control (Case et al, 2015) and the combination of hypnosis and imagery has been widely used in immune control (Gruzelier, 2002), surgical anxiety reduction (Hammond, 2010;Vagnoli et al, 2019), postoperative recovery (Lambert, 1996) and motor training (Torem, 1992;Newmark and Bogacki, 2005). Thus a combination of imagined massage and hypnosis may be a more promising strategy in clinical application, although future studies are needed to uncover the detailed behavioral effects and the underlying neural substrates.…”

Section: Behavioral and Neural Responses To Manual And Machine Adminimentioning

confidence: 99%

The Effects of Intranasal Oxytocin on Neural and Behavioral Responses to Social Touch in the Form of Massage

Chen

Zhang

et al. 2020

Front. Neurosci.

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Manually-administered massage can potently increase endogenous oxytocin concentrations and neural activity in social cognition and reward regions and intranasal oxytocin can increase the pleasantness of social touch. In the present study, we investigated whether intranasal oxytocin modulates behavioral and neural responses to foot massage applied manually or by machine using a randomized placebo-controlled within-subject pharmaco-fMRI design. 46 male participants underwent blocks of massage of each type where they both received and imagined receiving the massage. Intranasal oxytocin significantly increased subjective pleasantness ratings of the manual but not the machine massage and neural responses in key regions involved in reward (orbitofrontal cortex, dorsal striatum and ventral tegmental area), social cognition (superior temporal sulcus and inferior parietal lobule), emotion and salience (amygdala and anterior cingulate and insula) and default mode networks (medial prefrontal cortex, parahippocampal gyrus, posterior cingulate, and precuneus) as well as a number of sensory and motor processing regions. Both neural and behavioral effects of oxytocin occurred independent of whether subjects thought the massage was applied by a male or female masseur. These findings support the importance of oxytocin for enhancing positive behavioral and neural responses to social touch in the form of manually administered massage and that a combination of intranasal oxytocin and massage may have therapeutic potential in autism.Clinical Trials RegistrationThe Effects of Oxytocin on Social Touch; registration ID: NCT03278860; URL: https://clinicaltrials.gov/ct2/show/NCT03278860.

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Section: Behavioral and Neural Responses To Manual And Machine Adminimentioning

confidence: 99%

The Effects of Intranasal Oxytocin on Neural and Behavioral Responses to Social Touch in the Form of Massage

Chen

Zhang

et al. 2020

Front. Neurosci.

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“…This encouragement likely benefited the mental visualization of color. Guided visualization plays an important role in stress, anxiety, or pain reduction in some mind‐body interventions . Furthermore, empirical evidence demonstrated that emotion associations are highly similar when physically perceiving colors or reading color words .…”

Section: Discussionmentioning

confidence: 99%

To see or not to see: Importance of color perception to color therapy

Jonauskaitė

Tremea

Bürki

et al. 2020

Color Research & Application

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Color therapy, healing through color, supposedly works through the physical exposure to color. In two studies, we assessed stress and anxiety reduction after color exposure using a commercially available relaxation‐through‐color routine. Participants either completed the routine by looking at the accompanying color disks or at a white patch. In study 1 (longitudinal), 60 participants completed the routine three times, each testing session separated by a week. In study 2 (cross‐sectional), 63 participants completed half of the trials once. In both studies, we recorded a decrease in stress and anxiety levels comparing before‐after scores. In study 1, we recorded incremental decreases with each week. Crucially, decreases were the same whether participants (a) physically saw colors or not, and (b) completed the full or shortened version. We conclude that other factors but physical exposure to color explain changes in affective states associated with this and probably other color therapy routines.

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“…25 Mind-body therapies, like relaxation and guided imagery, decrease anxiety and help manage pain in children undergoing surgery. 26 Unfortunately, their integration into postoperative clinical care is fraught with challenges, including access to care, high cost, and provider availability. Using VR to deliver these therapies can increase accessibility and enhance acceptability, motivation, 37 and adherence in pediatric patients compared to methods without VR, making this therapy more engaging and relevant.…”

Section: Discussionmentioning

confidence: 99%

“…Nonpharmacologic alternatives that utilize mind-body based therapies delivered in a traditional format, like relaxation and slow breathing, have been shown to decrease anxiety and pain in children undergoing surgery. 26 Combining traditional mind-body therapies, such as relaxation and slow breathing with immersive VR, opens new possibilities for multimodal analgesia to maximize pain control while minimizing opioid consumption.…”

Section: Introductionmentioning

confidence: 99%

Guided Relaxation-Based Virtual Reality Transiently Reduces Acute Postoperative Pain and Anxiety in a Pediatric Population

Olbrecht

O’Conor

Williams

et al. 2020

Preprint

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Background: Virtual reality (VR)-based immersive games and content can distract or redirect attention. Distraction-based therapies, such as VR, have been used to reduce pain from acutely painful procedures. However, it is unlikely that distraction alone can produce the prolonged pain reduction required to manage sustained postoperative pain. Integration of VR with other pain reducing therapies, including mind-body techniques, may enhance their clinical impact. Slow breathing and relaxation techniques are used clinically to reduce pain in children. Incorporating techniques such as these into the immersive audio-visual VR experience has the potential to produce synergistic effects. The current pilot study assessed the ability of a single guided relaxation-based VR (VR-GR) session to decrease acute postoperative pain and anxiety in children and adolescents. We also explored whether pain catastrophizing and anxiety sensitivity influenced the ability of VR-GR to reduce these outcomes. Methods: A total of 51 children and adolescents (ages 7-21 years) with postoperative pain followed by the Acute Pain Service at Cincinnati Childrens Hospital Medical Center were recruited over an 8-month period to undergo a single VR-GR session. Prior to VR, patients completed pain catastrophizing (PCS-C) and anxiety sensitivity (CASI) questionnaires. The primary outcome was changes in pain intensity following VR-GR (immediately, 15, and 30 minutes). Secondary outcomes included changes in pain unpleasantness and anxiety. Results: Based on mixed effects models, VR-GR decreased pain intensity immediately (p < 0.001) and 30 minutes (p = 0.04) after the VR session, but not at 15 minutes (p = 0.16) post-session. Reductions in pain unpleasantness were observed during all time intervals (p < 0.001 at all intervals). Anxiety was reduced immediately (p = 0.02) but not at 15- (p = 0.08) or 30- (p = 0.30) minutes following VR-GR. Adjustment for covariates showed that patients with higher CASI reported greater reductions in pain intensity (p = 0.04) and unpleasantness (p = 0.01) following VR-GR. Pain catastrophizing did not impact changes in pain and anxiety following the VR session (all ps > 0.10). Conclusion: A single, short VR-GR session produced immediate and acute reductions in pain intensity, pain unpleasantness, and anxiety in children and adolescents with acute postoperative pain. These results encourage future randomized clinical trials to compare the effectiveness of VR-GR and mind-body based treatments to reduce postoperative pain outcomes and to reduce requirements for opioid medications during this period.

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Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study

Cited by 76 publications

References 54 publications

The Effects of Intranasal Oxytocin on Neural and Behavioral Responses to Social Touch in the Form of Massage

The Effects of Intranasal Oxytocin on Neural and Behavioral Responses to Social Touch in the Form of Massage

To see or not to see: Importance of color perception to color therapy

Guided Relaxation-Based Virtual Reality Transiently Reduces Acute Postoperative Pain and Anxiety in a Pediatric Population

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