Back to nature for pain relief

Panoramic views can provide a useful distraction

Distracting patients with images and sounds from nature has proved to be very effective in controlling pain in a certain type of surgical lung procedure.

The technique was used successfully by doctors to help patients deal with the process of bronchoscopy, which involves inserting a tube into the nose or throat to see the lungs.

Pain control was improved by around 43% in those who listened to the gurgle of a brook and looked at a colourful panorama during and after the process, according to the team at Johns Hopkins Medical Institutions in the US.

Relaxation is the key to pain control

Encouraged by the results, they are suggesting these so-called biophilic images and sounds should be tried in other invasive procedures such as endoscopies and interventional radiological examinations.

Dr Noah Lechtzin, a postdoctorate fellow at Hopkins said: "Natural sounds and images, if they are the right ones in the right format, are a safe, inexpensive and effective way to reduce the pain and anxiety of inserting tubes through the nose or mouth to see the lungs."

He will present the study at the American Thoracic Society's annual meeting on 20 May.

Dr Lechtzin emphasised that sight and sound distraction therapy is not a substitute for pain medication, but a way to enhance pain control.

Pain rating

The Hopkins group tested the natural sights and sounds on 41 men and women during their 25-minute bronchoscopies and three-hour recovery periods.

Individuals looked at cloth murals hung by their bedsides and listened to nature sounds through headphones and a tape player.

Thirty-nine similar patients underwent the procedures without distraction therapy, but with comparable levels of care.

Both groups of subjects filled out questionnaires rating their pain on a five point scale, along with their anxiety, perceptions of privacy, difficulty in breathing, willingness to have the procedure done again and safety.

'Fundamental'

Dr Gregory Diette, lead author of the Hopkins study, said: "Patients who listened to the nature sounds and looked at the mural during the bronchoscopy were 43% more likely to report pain control as very good or excellent."

Distraction therapy is used by the Input Pain Management Unit at London's St Thomas's hospital.

The unit treats people with chronic pain and teaches them how to manage it.

Administrator Gill Hancock said: "We teach our patients relaxation techniques, being music and pictures. It is a fundamental part of our work.

"Visual stimulation has been proved to help to relax them and physically relaxing your body reduces tension, which creates pain."

The Hopkins group now plans to test the distractions on bone marrow transplant patients who often have lengthy hospital visits and considerable pain.