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Pain clinics

Pain clinics

Relaxation and music therapy for postoperative pain

Relaxation techniques and music therapy are often used as an aid to management of the discomfort and to balance analgesia and side effects in patients about to undergo surgery.

Sources were used Medline (1982-1995), “Cumulative Index of Nursing” and “Allied Health Literature” (1982-1995) along with “PsychLit” (1971-1995) as a means of finding items that assessed the effects of relaxation and music on postoperative pain. 

It also sought in the Journal of Music Therapy “and other books by hand.Effectiveness data were obtained. 

The studies were classified according to the design (eg randomized, nonrandomized, uncontrolled).

No predefined instrument was used in obtaining the data. We performed a descriptive analysis.

Inclusion criteria were: published studies assessing the relaxation and / or music therapy as a treatment of postoperative pain in adults.

In clinical conditions such as surgical stress, and chronic and acute pain, music has proven to be an important therapeutic intervention.Research has been conducted in Germany and in the framework of the International Society for Music in Medicine, focused on the application of musical stimuli surgical conditions and treatments of pain (Spintge, 1982, Spintge and Drohan, 1987, 1991, Hatano, Oyama , Kogure, Okura and Spintge, 1983).

As referred Spintge under conditions of chronic pain, conscious awareness, self-esteem and subjective feelings are as impaired as cardiovascular systems and cardiorespiratory regulation, hormonal control and systems information processing motor, sensory and perception. 

Considering the disease as a holistic phenomenon that demands a unique approach that includes emotional, psychological, social and biological interventions have been tested non-pharmacological, including olfactory stimuli, optical and acoustic. In more than 120000 patients, the clinical results showed that it achieved a further reduction of anxiety and pain through the use of music (Spintge, 1999).

According to that author, the therapeutic application of music in multimodal treatment of acute and chronic pain can impact different levels of stress reactions and pain processing.

On the one hand, the author, the influence of music (a very complex stimulus) in consciousness is very powerful compared to other environmental stimuli. 

On the other hand, sub cortical centers of pain processing and emotional control such as the limbic system is directly inhibited. 

Moreover, the structures of the pain inhibitory descending central nervous system are activated in the way Melzack and Wall (1965, 1976) have described in their adapted version of the “gate control theory” (gate control theory).

In turn, the new concept of neuroplasticity (neuroplasticity) explains the genetic reprogramming of cells in the dorsal nerve root (dorsal root nerve cells) that have been previously sensitized against the entry of pain (Zieglagaensberger, 1998). “

These concepts force us to reconsider the role of so-called complementary therapies in general, because we found that the genome of nerve cells can be reprogrammed, thereby changing their functional capabilities. 

This process was considered impossible a few years ago.Furthermore, the continuous input of a stimulus identical influences this rescheduling.”

Another goal of the influence of music on pain perception, it claims Spintge has to do with muscle detonisación musicogénica (musicogenic detonisation muscle). 

The skeletal muscle proprioception influence emotional states and pain perception, and vice versa (Gellhorn, 1964; Roederer, 1985; Simons, 1988).

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