Brief preoperative psychological support and postoperative pain and anxiety in living kidney donors: A randomized controlled trial.

OBJECTIVE

This randomized controlled trial evaluated whether brief structured preoperative psychological support was associated with postoperative pain trajectories in living kidney donors.

METHODS

Adult living kidney donors scheduled for donor nephrectomy were randomized to standard care or brief psychological support delivered approximately one hour before surgery. The intervention included psychoeducation, diaphragmatic breathing, and guided imagery-based relaxation. The primary outcome was postoperative 0-10 Visual Analog Scale (VAS) pain trajectory during the first 48 h. Secondary outcomes included Beck Anxiety Inventory (BAI) scores, oxygen saturation, analgesic consumption, record-based antiemetic requirement, and early postoperative clinical events.

RESULTS

Of 130 donors assessed, 123 were randomized and analyzed (63 control, 60 intervention). VAS scores showed a significant group-by-time interaction (p = .04). After adjustment for multiple comparisons, VAS scores were lower in the intervention group at postoperative 12 h (estimated mean difference, -1.20; 95% CI, -1.74 to -0.66) and 24 h (-1.17; 95% CI, -1.71 to -0.63). BAI scores also showed a significant group-by-time interaction (p < .001), although baseline BAI scores were low in both groups. Total acetaminophen consumption and record-based antiemetic requirement were lower in the intervention group. No consistent intervention effect was observed for tramadol consumption, oxygen saturation, vomiting, desaturation, or hypotension.

CONCLUSION

Brief structured preoperative psychological support was associated with more favorable postoperative pain trajectories and lower postoperative anxiety scores in a sample with low baseline anxiety. These findings suggest that feasible psychoeducational and relaxation-based interventions may support early perioperative symptom management in this population.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT07261917.