Journal of PeriAnesthesia Nursing xxx (xxxx) xxx

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Jurnal Keperawatan PeriAnestesi

beranda: www. jopan. org

Penelitian

Pengaruh Teknik Relaksasi pada Nyeri Pascalaminektomi Akut:

Uji Klinis Terkontrol Acak Tiga Lengan
Sebuah b
Seyed Amir Hosein Pishgooie, PhD , Fakhridokht Akbari, MSc ,
c, d c, d e, f
Sahar Keyvanloo Shahrestanaki, MSc , Masoud Rezaei, MSc , Morteza Nasiri, MSc , Reza
Sebuah, *
Momen, MSc
a Departemen Keperawatan Perawatan Kritis, Sekolah Keperawatan, Universitas Ilmu Kedokteran AJA, Teheran, Iran
b Departemen Keperawatan, Fakultas Ilmu Kedokteran Behbahan, Behbahan, Iran
c Komite Penelitian Mahasiswa, Universitas Ilmu Kedokteran Iran, Teheran, Iran
d Pusat Penelitian Perawatan Keperawatan (NCRC), Sekolah Keperawatan dan Kebidanan, Universitas Ilmu Kedokteran Iran, Teheran, Iran
e Komite Penelitian Mahasiswa, Shiraz University of Medical Sciences, Shiraz, Iran
f Departemen Keperawatan Ruang Operasi, Sekolah Keperawatan dan Kebidanan, Universitas Ilmu Kedokteran Shiraz, Shiraz, Iran

abstrak

Tujuan: Penelitian ini membandingkan efek relaksasi dengan relaksasi otot progresif terhadap keparahan nyeri pasca
Kata kunci: laminektomi.
nyeri akut Desain: Uji coba kelompok acak, tidak buta, dan paralel tiga lengan.
laminektomi Metode: Penelitian dilakukan pada 93 pasien yang menjalani laminektomi lumbal. Pasien secara acak dibagi menjadi tiga
relaksasi otot
kelompok relaksasi Bensonþ perawatan rutin (n ¼ 31), relaksasi otot progresif þ perawatan rutin (n ¼ 31), dan perawatan
relaksasi
rutin (n ¼31). Dua metode relaksasi dilakukan pada 2 (waktu 1), 12 (waktu 2), dan 24 (waktu 3) jam setelah pasien sadar
penuh di bangsal pasca operasi. Tingkat keparahan rasa sakit yang menggunakan skala analog satu kali sebelum laminektomi,
sebelum dan juga 20 menit setelah setiap sesi relaksasi. Pada kelompok kontrol, keparahan nyeri yang diukur pada waktu yang
sama seperti pada kelompok relaksasi.

Temuan: Baik relaksasi Benson maupun relaksasi otot progresif menghasilkan suatu signifitidak dapat mengurangi keparahan
nyeri dibandingkan dengan kelompok kontrol pada ketiga waktu pengukuran (kecuali pada waktu 1 pada kelompok relaksasi
otot progresif). Namun, tidak ada yang berartifiTidak ada perbedaan yang ditemukan antara relaksasi Benson dan relaksasi otot
progresif di salah satu dari tiga waktu tersebut.
Kesimpulan: Hasil penelitian menunjukkan bahwa teknik relaksasi otot Benson dan progresif dapat menurunkan nyeri
postlaminektomi akut segera setelah operasi pada pasien dewasa.
© 2020 American Society of PeriAnesthesia Nurses. Diterbitkan oleh Elsevier, Inc. Semua hak dilindungi undang-
undang.

1
operasi ini. Untuk mengurangi nyeri jenis ini, pasien biasanya menggunakan
Pasien yang menjalani laminektomi mengalami nyeri pasca operasi 4,5
1,2 analgesik, yang berhubungan dengan efek samping ; oleh karena itu, ada
sedang hingga berat. Di Amerika Serikat, 14,8% orang dewasa dengan kebutuhan yang sangat besar untuk mengontrol nyeri pascalaminektomi
3 dengan menggunakan metode tambahan dan nonfarmakologis.
diagnosis nyeri mengalami nyeri postlaminektomi. Pada kebanyakan pasien,
nyeri mungkin berlangsung lama setelah laminektomi dan dianggap sebagai
salah satu komplikasi terpenting

pekerjaan dengan sebelumnya fitemuan dalam artikel internasional lengkap, membandingkan

Menipuflict yang menarik: Tidak ada untuk dilaporkan.
Pendanaan: Studi ini disetujui oleh AJA University of Medical Sciences, Teheran,
Iran (nomor registrasi: 595314).
Pernyataan: Penulis mengungkapkan bahwa sebagian dari artikel ini sebelumnya diterbitkan
dalam bahasa Persia, membandingkan dua kelompok relaksasi dan kontrol Benson (Momen R,
Roshandel M, Pishgooie SAH. Pengaruh metode relaksasi Benson pada keparahan nyeri setelah
laminektomi pada pasien yang dirawat Rumah sakit AJA. Milit Care Sci. 2017; 4 (3): 168-177).
Dalam pekerjaan ini, penulis memutuskan untuk menggabungkan sisanya
tiga kelompok relaksasi Benson, relaksasi otot progresif, dan kontrol. Untuk keperluan tersebut,
penulis mengikuti pernyataan Komite Etika Publikasi dan memperoleh izin dari jurnal Persia
untuk menggunakan kembalifitemuan. Dengan ini, penulis meyakinkanfirmed bahwa pekerjaan
ini memiliki sekunder fimenemukan yang tidak dibahas di fiartikel Persia pertama.
* Alamat korespondensi ke Reza Momen, Departemen Keperawatan Perawatan Kritis,
Sekolah Keperawatan, Universitas Ilmu Kedokteran AJA, Teheran, Iran.
Alamat email: Rezamomen88@yahoo.com (R. Momen).

https://doi.org/10.1016/j.jopan.2020.02.004
1089-9472 /©2020 American Society of PeriAnesthesia Nurses. Diterbitkan oleh Elsevier, Inc. Semua hak dilindungi undang-undang.
 Harap mengutip artikel ini sebagai: Pishgooie SAH et al., Efek Teknik Relaksasi pada Nyeri Pascalaminektomi Akut: Uji Klinis Terkontrol Acak Tiga Lengan,
Jurnal Keperawatan PeriAnesthesia, https://doi.org/10.1016/j.jopan.2020.02 0,004
2 Pishgooie dkk. / Journal of PeriAnesthesia Nursing xxx (xxxx) xxx
35
medical research. However, 31 patients in each group were considered
Akhir-akhir ini terapi relaksasi banyak mendapat perhatian sebagai adequate to compensate for any dropout.
6,7
intervensi keperawatan yang efektif untuk meredakan nyeri pasca operasi.
n 2 2 27
Relaksasi Benson dan relaksasi otot progresif adalah dua jenis terapi relaksasi lg;a;1 b d ð9:64Þð1Þ
umum yang disarankan untuk nyeri bedah karena mudah dipelajari dan ¼ 2 ¼ 2 ¼
8-14
Pm m 5:6 5:9 5:8 5:9 2 6:4 5:9 Þ 2
diterapkan oleh pasien dibandingkan dengan teknik lain. Þ ð Þ þð Þþð
ði
Relaksasi Benson dirancang oleh Herbert Benson pada tahun 1970-an
sebagai metode nonfarmakologis dan perilaku untuk mengatasi kecemasan
dan stres.
15,16
Teknik ini efektif untuk berbagai hasil yang berhubungan Sampling and Randomization
dengan kesehatan termasuk nyeri, stres, kecemasan, gangguan tidur,
parameter fisiologis, kelelahan, dan kualitas hidup karena menyeimbangkan Patients were selected by consecutive sampling method and randomly
fungsi hipotalamus posterior dan anterior dan mengurangi aktivitas simpatis. assigned to three groups of Benson relaxation (n ¼ 31), progressive muscle
sistem saraf dan sekresi katekolamin.
17-24 relaxation (n ¼ 31), or control (n ¼ 31). Random assignment was performed
by computer-generated random numbers, using simple randomization. For
Relaksasi otot progresif adalah metode sederhana dan murah, awalnya this purpose, a random number was allocated for each newly admitted patient.
25 All the data were kept confidential until the end of the study.
dirancang oleh Jacobson, yang membantu individu untuk merasa lebih
tenang melalui ketegangan otot berturut-turut dan relaksasi kelompok
26,27
otot. Cara ini dapat meredakan ketegangan dan kontraksi otot,
28-32 Procedures
memperlancar tidur, serta mengurangi kelelahan dan nyeri.
Penelitian sebelumnya telah menyelidiki efek dari metode relaksasi
8 The interventions were performed from October to December 2016.
tersebut di atas pada nyeri pasien setelah cangkok bypass arteri koroner,
9,11,13,14,33 10 Patients in the two experimental groups received relaxation techniques in
operasi caesar, operasi umum dan uro-logika, dan bedah
addition to routine care, whereas patients in the control group only received
12
ortopedi. Namun, sejauh pengetahuan kami, belum ada penelitian yang routine care during the same period. According to the standard postoperative
membandingkan efek dari teknik relaksasi yang disebutkan di atas pada care protocol at the recruitment centers, patients in all groups received
keparahan nyeri pasca operasi pada nyeri postlaminektori. Oleh karena itu, morphine (5 mg intravenous) and/or pethidine (25 mg intramuscular) at
penelitian ini dirancang untuk mengevaluasi pengaruh relaksasi Benson
certain intervals when it was necessary.
dibandingkan dengan relaksasi otot pro-gressive terhadap nyeri
postlaminektomi.
A day before the surgery, sufficient training on how to report pain using
the scale was given to all patients. Also, all patients were instructed to stay in
Bahan dan metode bed and rest during each intervention time. In addition, patients in the two
intervention groups learned how to do relaxation technique, using educational
Desain Studi video, brochures, and role play. The instruction was presented using simple
and under-standable sentences by the researcher, who was trained by a psy-
chologist. To make sure that the participants had learned the techniques,
Uji klinis tiga kelompok secara acak, tidak buta, terkontrol, dan paralel ini
34 patients in each intervention group were asked to perform each relaxation
adalah analisis sekunder dari penelitian yang dipublikasikan sebelumnya, technique step in the presence of the researcher to correct any errors.
disetujui oleh AJA University of Medical Sciences. Komite Etik setempat
menyetujui penelitian ini (nomor persetujuan: IR.AJAUMS.REC.1395.13),
dan persetujuan tertulis yang diinformasikan diperoleh dari semua peserta.
The relaxation for the two experimental groups was performed at three
Selain itu, uji coba tersebut terdaftar di Registri Uji Klinis Iran (nomor
times in the postoperative wards at 2, 12, and 24 hours after patients'
registrasi: IRCT20161213031385N3).
regaining full consciousness, each lasting 15 to 20 minutes. Patients were
asked to perform relaxation techniques under the supervision of the
researcher. All interventions were performed in a private room, and none of
Peserta the patients saw each other during the therapy session. In addition, all three
groups (even control group) were scheduled to rest in bed during the
Percobaan ini dilakukan pada pasien yang telah menjalani laminektomi aforementioned times for 20 minutes. For this purpose, the researcher helped
lumbal elektif dengan anestesi umum di rumah sakit tertentu dari Universitas the patients to lie down on their bed at an angle of 30 to 40 .
Ilmu Kedokteran AJA (Khanevadeh, Besat, dan Emam Reza). Pasien dengan
kriteria berikut memenuhi syarat:
(1) rentang usia 18 hingga 65 tahun, (2) kemampuan membaca dan menulis Participants in the first group were asked to do the Benson relaxation
dalam bahasa Persia, (3) tertarik melakukan teknik relaksasi, (4) memiliki izin 8,36
technique in the following six steps : (1) lying down in a comfortable
dari ahli bedah mereka, dan (5) berkelasfied sebagai American Society of
position, (2) close the eyes gradually, (3) loosening all muscles gradually
Anesthesiologists Physical Status grade I atau II. Kami tidak memasukkan
from head to toe and keeping them relaxed, (4) inhaling through the nose and
individu yang memiliki gangguan psikologis, gangguan pendengaran dan /
then exhaling from the mouth; saying one during exhalation (patients were
atau motorik, gangguan kognitif, kecanduan opi-oid; menggunakan obat tidur encouraged to perform this step in a relaxed condition), (5) repeating the steps
dan / atau obat pelemas otot; atau tidak mau berpartisipasi. 3 and 4 each for 7 minutes (patients were asked to open their eyes grad-ually
at the end of this step and were asked not to leave their position for a few
minutes), and (6) to stay calm and not worry about anything.
Ukuran sampel

9 Participants in the second experimental group received the progressive

Berdasarkan data yang diperoleh dari penelitian sebelumnya, ukuran
sampel optimal diperkirakan 27 pasien di setiap kelompok, dengan muscle relaxation. The patients were taught how to relax and contract their 16
mempertimbangkan kesalahan tipe I sebesar 5% ( Sebuah ¼ 0,05), main muscle groups, including muscles
kesalahan tipe II 80% (b ¼0,20; kekuasaan¼ 80%), and considering the
following formula that was suggested for comparison of more than two
groups in
Please cite this article as: Pishgooie SAH et al., Effects of Relaxation Techniques on Acute Postlaminectomy Pain: A Three-Arm
Randomized Controlled Clinical Trial, Journal of PeriAnesthesia Nursing, https://doi.org/10.1016/j.jopan.2020.02.004
Pishgooie et al. / Journal of PeriAnesthesia Nursing xxx (xxxx) xxx 3

of the right hand and forearm, right biceps, left hand and forearm, left biceps,
forearm, upper section of cheeks and nose, lower sec-tion of cheeks and nose,
neck and throat, chest, shoulders and upper part of back, abdominal region
and stomach, right thigh, right calf, right foot, left thigh, left calf, and left
foot. At each time, patients were asked to focus on tensing a muscle group and
to maintain tension for a maximum of 5 seconds and then relax them for 10
seconds. After tensing and relaxing each muscle group, participants were
asked to focus on feelings of kindness, tranquility, warmth, and flexibility for
30 seconds.
test was applied to examine the distribution of categorical variables between
groups. The Kolmogorov-Smirnov test was used to examine the normal
distribution of variables. If pain in one time was not normally distributed, it
was normalized to augment the reliability of the related statistical analyses
using log trans-formation. Hence, one-way analysis of variance (ANOVA)
was used to assess the differences between groups in terms of pain severity,
and the comparison between each two groups was done via post hoc analysis,
using the Scheffe's method. To determine the effects of relaxation techniques
on pain severity in each group, repeated-measures ANOVA was used.

Data Collection Results

A form was used to gather data on age, gender, marital status, education,
history of previous surgery, duration of admission before surgery, duration of
disease, duration of surgery, duration of anes-thesia, and recovery time. Also,
consumption of analgesics during the intervention was recorded for between-
group comparisons.
The severity of pain was measured by a nurse who was unaware of the
37
groups' allocation using the visual analog scale. Based on this scale, patients
were asked to select a score between 0 and 10 for their pain severity. Severity
was assessed before and 20 minutes after each relaxation time. In addition,
pain severity was deter-mined before laminectomy to consider baseline pain.
In the control group, data were collected at the same intervals as the
intervention groups, but without making them perform any intervention.
Follow-Up
All 93 patients completed the study and were included in the statistical
analysis (Figure 1).
Baseline Characteristics and Use of Analgesics
Mean age of patients was 42.62 ± 14.08 years. As shown in Table 1, no
significant differences were observed between groups in terms of baseline
characteristics. Moreover, no differences were observed between groups in
terms of analgesics use during the intervention time.

Statistical Analysis Pain Severity

All statistical analyses were conducted using SPSS, version 21 (SPSS, Pain severity was not significantly different between groups before
2 laminectomy and before performing relaxation techniques
Inc). P < .05 was considered statistically significant. The c

Enrollment Assessed for eligibility (n= 116)

Excluded (n=23)

Not meeting inclusion criteria (n= 19)

Declined to participate (n= 4)

Randomized (n= 93)

Allocation
Allocated to control (n= 31) Allocated to progressive muscle relaxation (n= 31) Allocated to Benson relaxation (n= 31)
Received allocated intervention (n=30) Received allocated intervention (n= 30) Received allocated intervention (n=30)

Did not receive allocated intervention (n= 0) Did not receive allocated intervention (n= 0) Did not receive allocated intervention (n= 0)

Follow-Up

Lost to follow-up (n= 0)

Lost to follow-up (n= 0)
Lost to follow-up (n= 0) Discontinued intervention (n= 0)
Discontinued intervention (n= 0)
Discontinued intervention (n= 0)

Analysis
Analysed (n= 31) Analysed (n= 31) Analysed (n= 31)

Excluded from analysis (n= 0) Excluded from analysis (n= 0) Excluded from analysis (n= 0)

Figure 1. The Consolidated Standards of Reporting Trials follow diagram of the patients' recruitment. This figure is available in color online at www.jopan.org.

Please cite this article as: Pishgooie SAH et al., Effects of Relaxation Techniques on Acute Postlaminectomy Pain: A Three-Arm
Randomized Controlled Clinical Trial, Journal of PeriAnesthesia Nursing, https://doi.org/10.1016/j.jopan.2020.02.004
Pishg
ooie
4 et al. /
Journ
al of
PeriA
nesth
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Nursi
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xxx
(xxxx
) xxx
Table 1

Characteristics of Patients Who Underwent Lumbar Laminectomy in Each Group

Variables Benson Relaxation Group Progressive Muscle Relaxation Group Control Group P*
n ¼ 31 (%)

Age (y) 40.96 ± 14.10 41.87 ± 14.09 45.06 ± 14.02 .487

Gender (female) 8 (25.8) 5 (16.1) 12 (38.7) .150
Marital status (married) 24 (77.4) 24 (77.4) 26 (83.9) .850
Education (collegiate) 13 (41.9) 6 (19.3) 7 (22.5) .350
History of previous surgery 12 (38.7) 20 (64.5) 17 (54.8) .140
Surgery indications
Herniated disc 10 (32.25) 12 (38.70) 15 (48.38) .426
Spinal stenosis 21 (67.75) 19 (61.30) 16 (51.62)
Disease duration (>1 y) 17 (54.8) 19 (61.3) 20 (64.5) .800
Admission duration (>2 d) 8 (25.8) 10 (31.2) 11 (35.4) .840
Surgery duration (min) 120.36 ± 30.11 123.69 ± 28.02 130.19 ± 31.52 .424
Anesthesia duration (min) 150.69 ± 40.23 153.17 ± 32.12 148.29 ± 36.19 .870
Recovery time (min) 60.32 ± 21.10 63.23 ± 16.50 59.01 ± 19.54 .675
Morphine consumption (mg) 11.32 ± 3.16 11.56 ± 4.32 12.54 ± 4.43 .450
Pethidine consumption (mg) 50.23 ± 7.32 48.25 ± 6.87 51.12 ± 6.98 .266

Data are presented as number (percentage) or mean ± SD.

* 2
Obtained from one-way analysis of variance or c test, where appropriate.

Based on our findings, performing the Benson relaxation had a favorable

in each time. However, it was significantly different after per-forming
relaxation techniques between groups in all three times (P < .05). In addition,
according to repeated-measures ANOVA, a significant reduction was found in
pain severity after each relaxa-tion time in the two experimental groups (P < .
001). Such reduction was also detected for patients in the control group (P < .
001) (Table 2).
Two-by-two comparison of groups in terms of changes in pain severity at
three times indicated that Benson relaxation effect on pain reduction was
greater than the control group (P ¼ .002) in time 1, but such effect was not
observed for the progressive muscle relaxation compared with the control
group. Considering times 2 and 3, effects of both Benson and progressive
muscle relaxation techniques were greater than the control group (P < .05).
However, no significant differences were found between the two relaxation
techniques in any of the times (Table 3).
Discussion
Our study revealed that Benson relaxation and progressive muscle
relaxation techniques were both beneficial for acute post-laminectomy pain,
and no significant difference was found in terms of pain severity between
these techniques. To the best of our knowledge, this trial is the first research to
compare the effects of aforementioned relaxation techniques on pain severity.
effect on pain reduction after laminectomy. This finding substantiates the
available data regarding the usefulness of Benson relaxation for pain
management in the postoperative period. In line with our study, Keihani et
10
al found that Benson relaxation for 10 to 20 minutes significantly reduced
postoperative spinal anesthesiaeinduced pain after elective general and
8
urologic sur-gery in comparison with routine care. Fayazi et al also reported
a pain-reducing effect of Benson relaxation on postoperative pain in patients
who underwent coronary artery bypass graft surgery. In addition, Benson
relaxation reduced pain severity significantly after cesarean section
9,11,33
surgery. Although our findings are in line with the mentioned findings
on the efficacy of Benson relaxation technique on postoperative pain, different
types of surgery and different approaches for performing Benson relaxation
technique should be considered.
We also found that performing the progressive muscle relaxa-tion
technique resulted in a significant reduction in post-laminectomy pain. This
finding could improve our understanding of the value of progressive muscle
relaxation technique on the control of postoperative pain. In two randomized
controlled clinical trials conducted on women who underwent cesarean
section, sig-nificant differences were found in pain scores between women
who performed five sessions of progressive muscle relaxation technique and
13,14
those who received routine care or instruction. However, a

Table 2
Pain Severity Before and 2, 12, and 24 Hours After Lumbar Laminectomy

Benson Relaxation Group Progressive Muscle Relaxation Group Control Group P*

(n ¼ 31)

Before surgery 3.06 ± 1.94 3.08 ± 1.53 3.09 ± 1.27 .99

2 h after surgery
Before intervention 6.45 ± 1.62 6.79 ± 1.97 6.67 ± 1.16 .70
After intervention 5.37 ± 1.76 5.95 ± 2.09 6.77 ± 1.17 .007
12 h after surgery
Before intervention 5.77 ± 1.54 5.80 ± 1.42 5.70 ± 1.46 .96
After intervention 4.80 ± 1.25 4.88 ± 1.59 5.77 ± 1.47 .01
24 h after surgery
Before intervention 4.59 ± 1.26 4.87 ± 1.68 4.83 ± 0.68 .65
After intervention 3.67 ± 1.14 3.83 ± 1.61 8.06 ± 0.92 <.001
Py <.001 <.001 <.001
Data are presented as mean ± SD.
* Obtained from one-way analysis of variance.
y Obtained from repeated-measures analysis of variance.

Please cite this article as: Pishgooie SAH et al., Effects of Relaxation Techniques on Acute Postlaminectomy Pain: A Three-Arm
Randomized Controlled Clinical Trial, Journal of PeriAnesthesia Nursing, https://doi.org/10.1016/j.jopan.2020.02.004
Pishgooie et al. / Journal of PeriAnesthesia Nursing xxx (xxxx) xxx 5
techniques as a nursing practice. In addition, patient education in these
Table 3 techniques is of merit. Further clinical trials are required to compare the
Two-by-Two Comparison of Groups in Terms of Pain Severity at 2, 12, and 24 Hours After effects of
Lumbar Laminectomy

Time Mean Difference P*

2 h after surgery
Benson relaxation vs control 1.4 .002
Progressive muscle relaxation vs control 0.82 .06
Benson vs progressive muscle relaxation 0.58 .18
12 h after surgery
Benson relaxation vs control 0.96 .01
Progressive muscle relaxation vs control 0.88 .01
Benson vs progressive muscle relaxation 0.08 .82
24 h after surgery
Benson relaxation vs control 1.38 .001
Progressive muscle relaxation vs control 1.22 .001
Benson vs progressive muscle relaxation 0.16 .61
*
Obtained from post hoc analysis, using the Scheffe's method.

12
study by Bialas et al on patients who underwent either total endoprosthesis
replacement of the knee or laminectomy found no significant difference
between the progressive muscle relaxation and control groups regarding pain
and analgesic use, but the length of hospital stay was shorter in the group with
progressive muscle relaxation. Different intervention time and types of
surgery might be the main reason for the observed discrepancy.

Several mechanisms by which relaxation techniques affect pain have been

suggested. Relaxation methods can reduce pain through a healing effect on
anxiety levels, cognitive and somatic anxiety, mood disturbance, and body
38,39
discomfort. Further-more, it has been shown that relaxation techniques
can affect the hypothalamus, which might reduce the activity of the sympa-
thetic nervous system and secretion of catecholamine. This action balances
40,41
heart rate, pulse rate, respiratory, and muscular spasms. Furthermore,
relaxation reduces consumption of oxygen and the production of carbon
dioxide in the body, affecting heart rate, pulse rate, and decreasing lactic acid
con-centrations in the blood. These changes increase the alpha/teta waves in
the brain and also stimulate secretion of endorphins, as natural analgesic
8,24,42
neurotransmitters, in neural synapses through cortical mechanisms.

Limitations

Several limitations of our study have to be taken into account. We could

not examine the effects of long-term administration of relaxation techniques
on surgery-related pain because of the short length of hospital stay. Also,
because of the small sample size, we were unable to examine if the favorable
effects of relaxation tech-niques were different between men and women.
Moreover, we could not blind the patients because of the nature of
interventions. However, none of the patients were aware of the treatment
types in the other groups because all interventions were performed in a private
room.

Conclusion

Benson and progressive muscle relaxation techniques seems to be

effective in reducing acute postlaminectomy pain severity. These interventions
could be applied by patients and nurses as comple-mentary and simple
methods along with routine care for managing postoperative pain. It is
recommended that educational programs be considered for perioperative
nursing students and also nurses to increase their knowledge in relaxation
other relaxation techniques with those assessed in the present study,
considering appropriate time and duration for performing relaxation
techniques.
Acknowledgments
This study was extracted from the thesis of R. Momen for MSc of critical
care nursing that was supported by AJA University of Medical Sciences,
Tehran, Iran. The authors appreciate the col-leagues, nurses, and patients for
their assistance in this project as well as the assistant of the Vice Chancellor
for Research and Technology of AJA University of Medical Sciences. The
authors thank Mr H. Argasi at the Research Consultation Center of Shiraz
University of Medical Sciences for his invaluable assistance in editing this
manuscript.
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Clinical Trial, Journal of PeriAnesthesia Nursing, https://doi.org/10.1016/j.jopan.2020.02.004
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Please cite this article as: Pishgooie SAH et al., Effects of Relaxation Techniques on Acute Postlaminectomy Pain: A Three-Arm Randomized Controlled
Clinical Trial, Journal of PeriAnesthesia Nursing, https://doi.org/10.1016/j.jopan.2020.02.004