Audiovisual distraction as an adjunct to pain and anxiety relief during minor surgery

Amy Drahota, E. Galloway, Rebecca Stores, Derek Ward, Martin Severs, Tara Dean

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Background - Minor surgery for ingrown toenails can provoke anxiety and the anaesthetic injection can be acutely painful. Distraction techniques may reduce the associated pain and anxiety.

Objective - To investigate an audiovisual distraction (Bedscapes™) on pain and anxiety during minor surgery for the correction of ingrown toenail.

Method - In a randomised controlled trial, patients (N = 152) with ingrown toenails requiring surgical correction under local anaesthesia were allocated to receive Bedscapes™ + standard care or standard care alone. Pain levels due to local anaesthetic injection were assessed post-procedure, and anxiety levels were assessed pre- and post-procedure in both groups. Follow-up focus groups were conducted with 14 patients allocated to the Bedscapes™ group, and one-to-one interviews were held with four podiatrists.

- Participants with high pre-procedure anxiety scores experienced greater pain on injection, and older patients reported lower pain than younger patients, regardless of group allocation. Bedscapes™ did not reduce pain or anxiety, and was apparently no more effective than interpersonal interaction between podiatry staff and the patient.

- Pain of injected anaesthesia correlates closely with pre-operative anxiety. Formal audiovisual distraction has no added benefit over interpersonal interaction in the alleviation of pain and anxiety in patients undergoing nail surgery.
Original languageEnglish
Pages (from-to)211-219
Number of pages9
JournalThe Foot
Issue number4
Early online date9 Jul 2008
Publication statusPublished - Dec 2008


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