Postoperative Progressive Relaxation Exercises for Pain and Anxiety After Emergency Surgery

This randomized, parallel-group clinical trial was conducted to evaluate the effectiveness and feasibility of postoperative progressive relaxation exercises (PRE) among patients undergoing emergency general surgery. Emergency surgical admissions provide no opportunity for preoperative preparation, and postoperative pain, anxiety, and autonomic instability are commonly intensified by acute physiological stress responses. The trial was designed to determine whether PRE, delivered exclusively after surgery, could reduce these symptoms and support early physiological recovery.

Following confirmation of postoperative stability at hour 6, eligible patients were randomly assigned in a 1:1 ratio to either the PRE intervention or routine postoperative care. The intervention consisted of standardized 30-minute sessions of progressive muscle relaxation conducted at postoperative hour 6, postoperative day 1, and postoperative day 2. Sessions followed a structured protocol including diaphragmatic breathing, sequential contraction-relaxation of major muscle groups, and a final integration phase. All sessions were delivered by a nurse trained in PRE.

Outcome assessments were conducted at prespecified time points using validated measures. Pain was evaluated with the Short-Form McGill Pain Questionnaire, anxiety with the State-Trait Anxiety Inventory, and physiological status through routine clinical monitoring of blood pressure, heart rate, respiratory rate, and oxygen saturation. Analyses examined both between-group differences and changes over time.

The study adhered to CONSORT guidelines for randomized trials and incorporated blinded outcome assessment and concealed allocation. No adverse events related to the intervention were reported, and all randomized participants completed follow-up.

Inclusion criteria

• Adults aged 18 years or older.
• Undergoing an emergency surgical procedure requiring postoperative hospitalization.
• Conscious, oriented, and hemodynamically stable by postoperative hour 6.
• Able to communicate and follow verbal instructions.
• No psychiatric, neurological, cognitive, or auditory impairment that would prevent participation.
• No chronic pain disorder and not using long-term opioids, sedatives, or anxiolytics before admission.
• Provided written informed consent.

Exclusion criteria

• Postoperative admission to the intensive care unit (ICU).
• Development of postoperative complications preventing participation (e.g., severe bleeding, respiratory distress, infection).
• Inability to complete all three scheduled PRE sessions.
• Postoperative confusion, delirium, or any condition limiting communication.