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Review
. 2022 Jul 9;2(1):31.
doi: 10.1186/s44158-022-00057-4.

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

Iacopo Lanini  1 , Timothy Amass  2 , Caterina Scirè Calabrisotto  1 , Sergio Fabbri  3 , Silvia Falsini  1   4 , Chiara Adembri  1   4 , Alessandro Di Filippo  1   4 , Stefano Romagnoli  1   4 , Gianluca Villa  1   4
Affiliations
Review

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

Iacopo Lanini et al. J Anesth Analg Crit Care. .

Abstract

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.

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Conflict of interest statement

GV received support for travel expenses, hotel accommodations, and registration to meetings from Baxter S.p.A. and Pall International. SR received honoraria for lectures, grants for consultancy, and support for travel expenses, hotel accommodations, and registration to meetings from Baxter, Orion Pharma, Vygon, ICU Medical, MSD, Medtronic, Baxter, BBraun, and Pall International.

Figures

Fig. 1
Fig. 1
Study selection process
Fig. 2
Fig. 2
Preoperative, intraoperative, and postoperative variables influencing the patient surgical stress response. This review specifically focuses on the effects of psychological optimization (i.e., a preoperative non-pharmacological variable) in reducing the surgical stress response
Fig. 3
Fig. 3
Effects of non-physical treatments on the surgical stress response
See this image and copyright information in PMC

References

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