{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:46:09Z","timestamp":1782308769839,"version":"3.54.5"},"reference-count":48,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Beth D. Darnall","award":["NIDA K24DA053564"],"award-info":[{"award-number":["NIDA K24DA053564"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,9,6]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Perioperative skills-based interventions may support non-pharmacological management of pain and opioid reduction after surgery. Such interventions may target and enhance predictors for surgical recovery and possibly reduce chronic postsurgical pain. Existing meta-analyses are limited by inclusion of studies that are either non-surgical or with outcomes occurring only in the hours after surgery. Lacking is a scoping review of studies testing perioperative skills-based interventions for postsurgical pain relief and opioid reduction in the days and months after surgery. We reviewed the efficacy of perioperative behavioral interventions; over what time frame and in which surgical populations efficacy evidence exists; and whether such interventions can prevent chronic postsurgical pain. 20 randomized trials were included, with the following intervention types: hypnosis, relaxation therapy, stress management training, mindfulness, mixed-type skills interventions (mind\u2013body skills, preoperative pain self-management, empowered relief for surgery); cognitive behavioral\u2013therapy (CBT); and mindfulness-based CBT. We summarize study methods, treatment specifics, and analgesic effects. No studies were designed to test intervention efficacy for preventing chronic postsurgical pain. Only two studies used active controls as the study comparator. Two studies showed positive effects on postsurgical opioid use. No studies tested whether the interventions enhanced time to pain cessation after surgery. Four studies demonstrated durable analgesic effects at 3\u201312 months after surgery. We describe the real-world practicality of intervention integration into the perioperative pathway and provide dissemination and implementation methodologies that may increase intervention uptake and therefore fulfill calls from national agencies to better integrate behavioral pain treatments into perioperative care.<\/jats:p>","DOI":"10.1136\/rapm-2024-105601","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T08:20:20Z","timestamp":1738743620000},"page":"93-101","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Upskilling pain relief after surgery: a scoping review of perioperative behavioral intervention efficacy and practical considerations for implementation"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-511X","authenticated-orcid":false,"given":"Beth D","family":"Darnall","sequence":"first","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Abshire","sequence":"additional","affiliation":[{"name":"Neurological Institute, Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rena E","family":"Courtney","sequence":"additional","affiliation":[{"name":"PREVAIL Center for Chronic Pain, Salem VA Medical Center, Salem, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Davin","sequence":"additional","affiliation":[{"name":"Neurological Institute, Center for Spine Health, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"2025101111493115000_50.2.93.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60160-X"},{"key":"2025101111493115000_50.2.93.2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.0168","article-title":"Factors Associated With Acute Pain Estimation, Postoperative Pain Resolution, Opioid Cessation, and Recovery: Secondary Analysis of a Randomized Clinical Trial","volume":"2","author":"Hah","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025101111493115000_50.2.93.3","unstructured":"The National pain strategy. U.S Health and Human Services; 2016. Available: https:\/\/www.iprcc.nih.gov\/National-Pain-Strategy\/Overview"},{"key":"2025101111493115000_50.2.93.4","unstructured":"NIH interagency pain research coordinating committee. 2015. Available: http:\/\/iprcc.nih.gov\/National_Pain_Strategy\/NPS_Main.html"},{"key":"2025101111493115000_50.2.93.5","unstructured":"Pain management best practices inter-agency task force report. 2019. 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A randomized controlled trial","volume":"44","author":"Sun","year":"2020","journal-title":"Int Orthop"},{"key":"2025101111493115000_50.2.93.46","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.1007\/s40520-021-01870-7","article-title":"Cognitive behavioral therapy cannot relieve postoperative pain and improve joint function after total knee arthroplasty in patients aged 70 years and older","volume":"33","author":"Chen","year":"2021","journal-title":"Aging Clin Exp Res"},{"key":"2025101111493115000_50.2.93.47","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1177\/0269215518755426","article-title":"Home-based pre-surgical psychological intervention for knee osteoarthritis (HAPPiKNEES): a feasibility randomized controlled trial","volume":"32","author":"das Nair","year":"2018","journal-title":"Clin Rehabil"},{"key":"2025101111493115000_50.2.93.48","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/BRS.0000000000000843","article-title":"Does a Preoperative Cognitive-Behavioral Intervention Affect Disability, Pain Behavior, Pain, and Return to Work the First Year After Lumbar Spinal Fusion Surgery?","volume":"40","author":"Rolving","year":"2015","journal-title":"Spine (Phila Pa 1986)"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2024-105601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:49:41Z","timestamp":1760208581000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2024-105601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":48,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,5]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/rapm-2024-105601"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2024-105601","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}