Psychological treatments to reduce pain in people undergoing open heart surgery

Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S


Acute postoperative pain is one of the most disturbing complaints after open heart surgery. It is related to impaired wound healing, chronic pain, or depression. Psychological treatment is designed to improve participant’ knowledge and to alter surgery-related mental distress, negative beliefs and noncompliance. It aims to reduce pain and anxiety, and to improve the postoperative recovery after open heart surgery.

This is an update of a review previously published in 2014 investigating whether psychological treatment could successfully reduce acute postoperative pain and improve the course of physical and psychological recovery of people undergoing open heart surgery.

Study characteristics

We found 23 studies, including a total of 2669 participants, which reported effects of psychological treatment compared to a control group without psychological treatment on pain intensity, use of pain medication, mental distress, mobility, or time to extubation after surgery.

Key findings and quality of evidence

We rated the quality of the evidence from studies using four levels: very low, low, moderate, or high. Very low-quality evidence means that we are very uncertain about the results. High-quality evidence means that we are very confident in the results.

We do not know if psychological treatment reduces pain intensity, enhances mobility, or decreases intubation time after open heart surgery. This is because there were not enough data to answer some parts of our review question, because there were problems with the design of some studies, or because results were conflicting. We only found very low to moderate-quality evidence for these outcomes.

We found moderate-quality evidence that psychological treatment could reduce mental distress. This means that we are moderately certain about the results because there were psychological treatments that clearly reduced distress whereas others did not.

The evidence in our review is current to February 2017.

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