Effects of Mindfulness on Postoperative Pain, Anxiety, and Opioid Use: An Integrative Review.

Objectives: This integrative review describes using mindfulness to reduce pain and anxiety during the perioperative period in surgical patients. As an exploratory aim, the relationship between mindfulness and opioid use after surgery was also explored.

Methods: CINAHL, PubMed and EMBASE databases were queried to identify articles examining the relationship between mindfulness, postoperative pain and opioid consumption, and preoperative anxiety in patients undergoing surgery. Seventeen studies were included in the review, encompassing 1,454 patients.

Results: Twelve articles focused on postoperative pain as the primary outcome and 11 of these reported that mindfulness decreased pain scores, mainly after postoperative day seven. Of these 12, seven studies measured opioid consumption and two reported an association between mindfulness and reduction in the use of opioid pain medications. Five articles focused on preoperative anxiety as the primary outcome, and two demonstrated that mindfulness was associated with a statistically significant reduction in anxiety.

Conclusions: Evidence suggests that mindfulness has a significant impact on postoperative pain, particularly pain more than one week after surgery. There was limited evidence supporting the use of mindfulness to reduce opioid consumption postoperatively. Similarly, mixed effects were reported describing the use of mindfulness to reduce anxiety before surgery. More research is needed to investigate the impact of mindfulness on pain after surgery and opioid consumption, as well as its impact on anxiety before surgery.

Nursing practice implications: Integrating mindfulness into surgical pathways could have positive effects on pain and anxiety for patients during the perioperative and postoperative phases of care.