Rx Good Vibes : mind-body medicine for surgical pain

Record relief

In a new study from Nowak et al., the benefits of a recording played during anesthesia had marked impacts on patients pain levels hours to days later.

383 patients were recruited consecutively from a large hospital in Germany prior to receiving surgery.

Patients were randomized to groups with a reassuring recording, which told patients of the care being taken by their surgeons and emphasized their safety and well-being, or a blank tape. Patients were unaware of which tape they were given, and were under anesthesia while the recording was played.

Despite, or perhaps because of, the altered state of consciousness (anesthesia has been theorized to be a hypnosis like state wherin patients are increasingly sensitive to suggestion), patients reported significantly lower pain levels in the hours immediately following the surgery, took lower doses of opiate pain relieving medication, and were significantly likely to not need medication at all.

Among patients who listened to the recording :

What does this mean?

Polyvagal theory predicts lower pain when safety is assured

The nociceptive fibers that are responsible for our perception of pain are bi-directional – while information from the body goes to the brain, pain is modulated in the opposite direction via endogenous opioid pathways and other non-opioid endogenous molecular mediators of pain.

The narrative context of pain can greatly influence the way that it is perceived – pain that is thought to be harmful is more subjectively painful than pain that is known to be harmless, and expectations around the experience have been shown to greatly modulate the perceived intensity of pain (Koyama et al., 2004).

Long story short

1. Your mind affects your body’s physical processes even when you aren’t conscious
2. A little reassurance goes a long way!