Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review
Open accessAbstract
A maladaptive response to surgical stress might lead to postoperative complications. A multidisciplinary approach aimed at controlling the surgical stress response may reduce procedural complications and improve patients’ quality of life in the short and long term. Several studies suggest that psychological interventions may interact with the pathophysiology of surgical stress response, potentially influencing wound repair, innate and adaptive immunity, inflammation, perception of pain, and patients’ mood. The aim of this systematic review is to summarise the effects of perioperative psychological interventions on surgical pain and/or anxiety in adult patients scheduled for elective general abdominal and/or urologic surgery. We conducted a systematic review of controlled clinical trials and observational studies involving psychological interventions for adult patients scheduled for elective general abdominal and/or urologic surgery. Only studies reporting pain and/or anxiety among outcome measures were included in the systematic review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioural therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis and (6) coping strategies. We examined 2174 papers. Among these, 9 studies were considered eligible for inclusion in this systematic review (1126 patients cumulatively): 8 are randomised controlled trials and 1 is an observational prospective pre/post study. Psychological characteristics widely influence the pathophysiological mechanisms underlying the neuroendocrine and inflammatory response to surgical stress, potentially interfering with surgical outcomes. Psychological interventions are technically feasible and realistically applicable perioperatively during abdominal and/or urologic surgery; they influence the pathophysiological mechanisms underlying maladaptive surgical stress response and might have positive effects on patients’ surgical outcomes, such as pain and anxiety.
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Most previous reviews examined specific surgery types or limited outcomes to the acute postoperative period.
“Most of the previous reviews have examined the effects of psychological interventions for specific types of interventions, such as orthopedic surgery, cardiac surgery, or abdominal surgery, 52,56,64,70 and/or limited the outcomes to the acute postoperative period.1,34,52,56”
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- Authors
- Villa, G., Lanini, I., Amass, T., Bocciero, V., Scirè Calabrisotto, C., Chelazzi, C., Romagnoli, S., De Gaudio, A. R., & Lauro Grotto, R.
- Affiliations
- Azienda Ospedaliero-Universitaria Careggi (IT)
- University of Florence (IT)
- University of Colorado Denver (US)
- Corresponding author
- Villa, Gianluca
- Venue
- Perioperative Medicine
- Published
- 2020-12
- Volume
- 9
- Issue
- 1
- Pages
- 38-38
- ISSN
- 2047-0525 (ISSN-L)
- PMC
- PMC7722323
- OpenAlex
- W3111203070
- Cited by
- 128
- References
- 42
- Citations by year
- 2026: 19 · 2025: 42 · 2024: 26 · 2023: 12 · 2022: 17 · 2021: 12
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Perioperative Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Funders
- Fondazione Cassa di Risparmio di Firenze (2014.0679)
- Philip and Irene Toll Gage Foundation (NA)
- Topics
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- psychological intervention, perioperative anxiety, postoperative pain, surgical stress response, abdominal surgery, urologic surgery, relaxation techniques, cognitive behavioral therapy, mindfulness, narrative medicine, hypnosis, coping strategies, neuroendocrine response, inflammation, surgical outcomes
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