Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery—A Systematic Review and Meta-Analysis

PurposeTo compare the effectiveness of audiovisual and relaxation-based intraoperative interventions for their impact on intraoperative pain and anxiety.DesignSystematic review and meta-analysis.MethodsThe following databases were searched for articles published between 1990 and January 2014: MEDLINE, PsychINFO, CINAHL, and Web of Science. Twenty randomized trials meeting the following inclusion criteria were included; adult participants undergoing elective outpatient surgery under local anesthetic using a form of distraction-based intraoperative intervention for the management of anxiety and pain.FindingThirty percent of studies reviewed found that intraoperative interventions improved patient experience in comparison to treatment as usual, 20% of studies were inconclusive, and 50% of studies found that interventions during surgery provided no benefit.ConclusionsBoth relaxation-based and audiovisual interventions were found to be efficacious for pain and anxiety management during surgery under local anesthetic. This review indicates that relaxation-based interventions could be more effective than audiovisual interventions for managing intraoperative anxiety.