The benefit of preoperative psychotherapy on surgical outcome after inguinal hernia repair and thyroid gland surgery

This randomized controlled trial aims to evaluate the influence of preopera tive relaxation techniques on postoperative outcomes. From January 1997 to June 1998 208 patients were operated on for primary inguinal hernia or goit er. The patients were randomized into two groups: Group A (n = 103) underwe nt the surgical treatment with a preoperative visualization therapy. Group B (n = 105) underwent the surgical treatment without a preoperative therapy . Patients with age under 18 years, ASA-status IV-V, recurrent inguinal her nia or recurrent goiter and malignant neoplasms were excluded from the stud y. There were no differences in age, sex, duration of the operation, traini ng of the surgeon, and preoperative blood parameters between the two groups . Results: During the postoperative follow-up we observed more hematomas (gro up A with visualization therapy: 30.3 %, group B without visualization ther apy: 44.4 %) as well as more pain (group A: 4.2, group B: 5.2) and analgesi c consumption (group A: 59.7 mg Tramadol HCL, group B: 72.5 mg Tramadol HCL ) in group B (p < 0.05). There were no significant differences in infection s, nausea, hypocalcemia, tetania, recurrent nerve palsy, fever. Conclusions: Preoperative visualization therapy reduces significantly the n umber of postoperative hematomas after inguinal hernia repair. Furthermore a decrease of analgesic requirements after surgical treatment was observed.