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A Randomized Trial

Allison R. Mitchinson, MPH, NCTMB; Hyungjin Myra Kim, ScD; Jack M. Rosenberg, MD; Michael Geisser, PhD; Marvin Kirsh, MD; Dolores Cikrit, MD; Daniel B. Hinshaw, MD

Arch Surg. 2007;142(12):1158-1167.

Hypothesis  Adjuvant massage therapy improves pain management and postoperative anxiety among many patients who experience unrelieved postoperative pain. Pharmacologic interventions alone may not address all of the factors involved in the experience of pain.

Design  Randomized controlled trial.

Setting  Department of Veterans Affairs hospitals in Ann Arbor, Michigan, and Indianapolis, Indiana.

Patients  Six hundred five veterans (mean age, 64 years) undergoing major surgery from February 1, 2003, through January 31, 2005.

Interventions  Patients were assigned to the following 3 groups: (1) control (routine care), (2) individualized attention from a massage therapist (20 minutes), or (3) back massage by a massage therapist each evening for up to 5 postoperative days.

Main Outcome Measure  Short- and long-term (> 4 days) pain intensity, pain unpleasantness, and anxiety measured by visual analog scales.

Results  Compared with the control group, patients in the massage group experienced short-term (preintervention vs postintervention) decreases in pain intensity (P = .001), pain unpleasantness (P < .001), and anxiety (P = .007). In addition, patients in the massage group experienced a faster rate of decrease in pain intensity (P = .02) and unpleasantness (P = .01) during the first 4 postoperative days compared with the control group. There were no differences in the rates of decrease in long-term anxiety, length of stay, opiate use, or complications across the 3 groups.

Conclusion  Massage is an effective and safe adjuvant therapy for the relief of acute postoperative pain in patients undergoing major operations.

Author Affiliations: Center for Practice Management and Outcomes Research, Health Services Research and Development (Ms Mitchinson and Dr Kim), Department of Anesthesiology and Physical Medicine and Rehabilitation (Dr Rosenberg), and Sections of Cardiac Surgery (Dr Kirsh) and General Surgery, Geriatrics and Palliative Care Program (Dr Hinshaw), Department of Surgery, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan; Center for Statistical Consultation and Research (Dr Kim), Departments of Anesthesiology (Dr Rosenberg) and Physical Medicine and Rehabilitation (Drs Rosenberg and Geisser), and Sections of Cardiac Surgery (Dr Kirsh) and General Surgery (Dr Hinshaw), Department of Surgery, University of Michigan, Ann Arbor; and Departments of Surgery, Richard L. Roudebush Veterans Affairs Medical Center and Indiana University, Indianapolis (Dr Cikrit).

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