Introduction
During the last decade, there has been an increasing interest within orthopedic surgery to decrease reliance on narcotics for pain management. Non-pharmacologic interventions, such as education, can decrease narcotic consumption after arthroscopic rotator cuff repair (ARCR). Another non-pharmacologic intervention, the use of relaxation exercises, has been promoted for pain management; however, its’ effect has not been investigated following ARCR. The purpose of this investigation was to evaluate the effects of relaxation exercises on post-operative pain and narcotics use after ARCR.
Methods
This was a prospective, randomized, controlled trial evaluating 151 consecutive patients undergoing ARCR. The study group (n: 75) received education materials including a 5 minute video explaining relaxation breathing techniques, while the control group (n: 75) received no relaxation education. Both groups received standardized post-op care including oxycodone/acetaminophen, and cryotherapy. Patients recorded a 5-day journal of their pain level and opioid consumption. Patients were then queried with ASES and SANE questionnaires pre-operatively, and 2, 6, 12, 18, and 24 weeks post-operatively.
Results
Ninety-five percent of patients completed the follow-up survey. Sixty-three percent (43/68) of study group patients reported that the relaxation techniques decreased their pain levels, while 37% said that it had no effect on their pain. However, there were no significant differences between the study and control groups in post-op pain measures on any post-op day (1-5), p > 0.05. At two weeks post-op the study group consumed significantly less narcotics than the control group (avg. 21.7 doses vs. 29.7, p= 0.016), and 51% were still performing the relaxation techniques. There were no significant differences in ASES and SANE scores at each time point throughout the study period.
Conclusion
While the effect on post-op pain is uncertain, relaxation techniques can provide an easy to implement, non-pharmacologic strategy to significantly decrease narcotics consumption after ARCR.