Effect of meditation and relaxation therapy on preoperative anxiety and stress in oral squamous cell carcinoma patients scheduled for oral and maxillofacial surgery: An experimental study.

Meditation and relaxation therapy (MRT) given for 21 days before surgery significantly reduced stress and anxiety in patients with oral squamous cell carcinoma (OSCC). In a randomized trial of 50 patients (stage II or III OSCC), those who practiced Sukhasana, Anulom Vilom, Omkar chanting, and Shavasana for 30 minutes twice daily had lower serum cortisol, systolic and diastolic blood pressure, pulse rate, respiratory rate, and anxiety scores on the day of surgery compared to the control group. All differences were statistically significant, with P values of 0.0001. MRT offers a non-pharmacological way to improve psychological and physical stability before OSCC surgery.

Study at a glance

Abstract

The diagnosis of oral squamous cell carcinoma [OSCC] and its treatment phase is emotionally demanding for the patient and challenging for the surgeon. The induction of stress and anxiety is unavoidable in these patients. It becomes very important for the patient to have psychological as well as physical stability during this treatment phase. Various studies have reported the beneficial effect of meditation along with relaxation therapy on healthy individuals but the beneficial effect of meditation and relaxation therapy [MRT] to reduce stress and anxiety preoperatively in OSCC patients has not been reported in scientific literature. The aim of this study was to study the effect of MRT on preoperative anxiety and stress in OSCC patients undergoing for oral and maxillofacial surgery. An experimental, parallel study design was carried out with randomization of patients into experimental[25] and control group[25] with allocation ratio 1:1 in 50 patients diagnosed with OSCC [stage II or III] scheduled for oral and maxillofacial surgery with general anesthesia. The biopsy which was the prerequisite for the diagnosis was taken. Twenty-one days before surgery in experimental group, patients were oriented about meditation and relaxation exercises. The reorientation of MRT was done from the day of admission twice a day till the day of surgery. Physiological parameters for stress and anxiety like heart rate [HR], blood pressure [BP], pulse rate [PR], and respiratory rate [RR] were evaluated on 1st day of MRT at 9 am and on the day of surgery. The serum cortisol which was quantitative parameter for stress was evaluated 1st day of MRT at 9 am fasting and on the day of surgery. The qualitative analysis for anxiety was done preoperatively using visual analog scale on the 1st day before MRT and compared with the values on the day of surgery after MRT at a specific time. Paired t-test analysis was used intragroup whereas unpaired t-test was used intergroup between experimental and control groups with significance at P = 0.05 and highly significant at P = 0.0001. The serum cortisol was significantly less in the experimental group over control group with t = 7.04 and P = 0.0001. The systolic and diastolic BP, pulse rate, respiratory rate, and anxiety in the experimental group reported significantly less rate compared to the control group with t = 5.66, t = 22.2, t = 11.93, t = 27.71, and P = 0.0001. In our study, MRT in the form of Sukhasana, Anulom Vilom, Omkar chanting, and Shavasana for 30 min twice daily has shown positive effect to reduce stress and anxiety. The serum cortisol as a quantitative parameter has been effectively evaluated in this benchmark study.