The influence of psychological interventions on surgical outcomes: a systematic review


Author: Iacopo Lanini1, Timothy Amass2, Caterina Scirè Calabrisotto1, Sergio Fabbri3, Silvia Falsini1,4, Chiara Adembri1,4, Alessandro Di Filippo1,4, Stefano Romagnoli1,4, Gianluca Villa1,4

Affiliation: <sup>1</sup> Department of Health Sciences, Section of Anesthesiology, and Intensive Care, University of Florence, Florence, Italy.

<sup>2</sup> Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, CO, USA.

<sup>3</sup> Department of Health Sciences, Section of Anesthesiology, and Intensive Care, University of Florence, Florence, Italy. sergio.fabbri@unifi.it.

<sup>4</sup> Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Conference/Journal: J Anesth Analg Crit Care
Date published: 2022 Jul 9
Other:
 Volume ID: 2   ,  Issue ID: 1   ,  Pages: 31   ,  Special Notes: doi: 10.1186/s44158-022-00057-4.   ,  Word Count: 225  
    Background:

An amplified and/or prolonged surgical stress response might overcome the organs' functional reserve, thus leading to postoperative complications. The aim of this systematic literature review is to underline how specific psychological interventions may contribute to improve surgical outcomes through the positive modulation of the surgical stress response in surgical patients.



Methods:

We conducted a comprehensive literature search in the Cochrane Register of Controlled Trials, PubMed, EMBASE, Scopus, PsycINFO, and CINAHL databases. Only studies published in English from Jan 2000 to Apr 2022 and reporting pain and/or anxiety among outcome measures were included in the review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioral therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis, and (6) coping strategies.



Results:

Among 3167 records identified in the literature, 5 papers were considered eligible for inclusion in this review because reporting the effects that psychological features have on neurochemical signaling during perioperative metabolic adaptation and those metabolic and clinical effects that the psychological interventions had on the observed population.



Conclusion:

Our findings confirm that psychological interventions may contribute to improve surgical outcomes via the positive influence on patients' metabolic surgical stress response. A multidisciplinary approach integrating physical and non-physical therapies can be considered a good strategy to successfully improve surgical outcomes in the perioperative period.



Keywords: Cognitive behavior therapy; Metabolic stress response; Mindfulness; Narrative medicine; Perioperative care.



PMID: 37386591 PMCID: PMC10245433 DOI: 10.1186/s44158-022-00057-4