395: Digitally Based Education and Recreation for Acute Pain: An Interventional Pilot Study

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute postsurgical pain, Psychology, Non-pharmacological treatments, Treatment/management

Background and Aims: Postoperative opioid use contributes to negative outcomes such as respiratory depression and persistent use, particularly for those undergoing bariatric surgery (1). However, studies have demonstrated that patients who receive video-based training on pain medications have reduced postoperative pain levels and opioid consumption (2). In addition, digital psychological and recreational interventions for acute pain show promise as safe and effective adjuncts to pain regimens (3). This pilot study sought to determine whether an educational video and digital media program, disseminated through a commercially available digital tablet device, were effective in mitigating pain and reducing opioid use.

Methods: Patients scheduled for vertical sleeve gastrectomy (VSG) or Roux en-Y gastric bypass (RYGB) were consented and randomized into experimental and control groups. Both groups received standard education and recreation. Group A received additional education about pain medications via video and a digital tablet containing recreational/therapeutic apps. Clinical and demographic data was collected and primary endpoints included numeric pain rating scale (NPRS) scores, morphine equivalent daily (MED), and adverse events. Secondary endpoints for both groups included patient satisfaction as reported in an exit survey, tablet usage data, and correlations between selected endpoints. Potential improvements in study design were also noted.

Results: Of 48 participants, 23 were in Group A (intervention) and 25 in Group B (control). Group A had 35.84% lower MED on postoperative day one. Mean NPRS scores during admission were similar for both groups. The mean tablet use time was 40.58 minutes (SD=76.32). The mean times for individual apps were meditation (17.77 mins.), breathing (12.29 mins.), art (9.38 mins.), and music (5.00 mins.). Patients in both groups reported that digital media helped with pain, anxiety, sleep, mood, unpleasant thoughts, and using less pain medications. There were no adverse events.

Conclusions: Our results demonstrate that digitally delivered education and therapeutic recreation play a positive role in reducing opioid use and that patients spent a significant amount of time using a digital tablet when it was provided postoperatively. Meditation was the most used app option. Patients continued to use digital media for therapeutic purposes after discharge and felt that it probably helped them with pain and using less pain medication. More research is needed to determine the possible benefits of a similar program in larger populations.

References: 1. Young JC Dasgupta N Chidgey BA Jonsson Funk M. Postsurgical Opioid Prescriptions and Risk of Long-term Use: An Observational Cohort Study Across the United States. Annals ofsurgery 2021 Apr 1; 1528-1140 (Electronic): PMID: 31404007.
2. Gündüz CS, Çalişkan N. The Effect of Preoperative Video Based Pain Training on Postoperative Pain and Analgesic Use in Patients Undergoing Total Knee Arthroplasty: A Non-randomized Control Group Intervention Study. Clin Nurs Res. 2021 Jul;30(6):741-752. PMID: 33383995.
3. Oliveira A, Gevirtz R, Hubbard D. A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries. Spine (Phila Pa 1976). 2006 Jul 1;31(15):1652-7. PMID: 16816758.

Presenting Author: Daniel Adams
Submitting Author: Daniel Adams

Senior Author: Daniel Adams

IASP 2026 Global Year theme of Neuropathic Pain: No

• John A. Das: MD - Department of Medicine, Western Reserve Hospital
• Tonya Marie Thomas: CNP - Department of Bariatric Surgery, Western Reserve Hospital
• Walter J. Chlysta: MD - Department of Bariatric Surgery, Western Reserve Hospital
• Dmitri Souza: MD, PhD - Center for Pain Medicine, Western Reserve Hospital