The Impact of Massage on Children’s Pain and Anxiety After Cardiovascular Surgery

Massage has an important role in post-surgical patients; it has been incorporated in a rehabilitation program to improve recovery. A review published in 2016 showed that massage therapy in the postoperative period decreased pain and lowered anxiety in patients that undergone cardiac surgery.

A pilot study from Cincinnati Children’s Hospital evaluated the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery. Sixty pediatric heart surgery patients between ages 6 and 18 years at an academic children’s hospital were recruited. They were randomised to receive either massage therapy or a standard of care plus three reading visits. The study examined the effects of massage therapy versus standard of care on postoperative pain and anxiety, and the effects of opioid and benzodiazepine exposure in patients receiving massage therapy.

The study found no adverse events related to massage or reading interventions in either group. There is no statistically significant difference in Pain or State-Trait Anxiety scores in the initial 24 hours after heart surgery and within 48 hours of transfer to the acute care unit after controlling for age, gender, and Risk Adjustment for Congenital Heart Surgery score. However, children receiving massage therapy had significantly lower State-Trait Anxiety scores after receiving massage therapy at the time of discharge than children receiving standard of care plus three reading visits.

There was no difference in total opioid exposure during the first three postoperative days between groups. In contrast, children receiving massage therapy had significantly lower total benzodiazepine exposure in the immediate three days following heart surgery, and number of benzodiazepine PRN doses.

The authors concluded that the pilot study demonstrated the safety and feasibility of implementing massage therapy in the immediate postoperative period in paediatric heart surgery patients. Massage therapy decrease State-Trait Anxiety scores at discharge and lower total exposure to benzodiazepines. The authors suggested that preventing postoperative complications such as delirium through nonpharmacologic interventions warrants further evaluation.