Clinical guidelines for pain management require evaluation of the best research results available on effectiveness of interventions to relieve pain. In addition to statistical significance, a simple effects benchmark to communicate to practitioners is the number needed to treat (NNT). In this secondary analysis of a randomized 2X2 factorial design study (N=517,18-25 y/o) in which those who received taped relaxation/music after major abdominal surgery had significantly less sensation and distress of pain than those who did not on day 1am, p=.001 and pm, p=.05 and day 2am, p=.05 (Good et al. 2006). No significance was found at tests on day of surgery or day 2pm. Intervention effects were measured with pain sensation and distress VAS before and after five 20-minute tests. In persons with => 30mm pretest pain, proportions of 50% and 35% relief were calculated for each group, using mean pretest-posttest sensation/distress scores for the five mixed-significance tests and for the three significant tests. Absolute Risk Reduction (ARR)=proportion of relief in the relaxation/music groups minus that in groups without music; NNT=1/ARR. The NNT for 35% relief was 5 across three significant tests and 6 across five mixed tests. The NNT for 50% relief was 9 across three significant tests and 14 across five mixed tests. In addition to opioid analgesics, clinicians can treat 5 abdominal surgery patients with relaxation/music on day 1am/pm and day 2am to have 1 with 35% relief who would not have received that much, if not exposed to music. Clinicians must treat more people for 50% relief or on the day of surgery or day 2pm.

Funded by National Institute of Nursing Research: Marion Good, RO1-NR3933 and General Clinical Research Center, Case Western Reserve University.

Good, Albert, Anderson, Wotman, Cong (2006). Supplementing relaxation and music for postoperative pain. The Journal of Pain (7)4,Supplement)68.