Effectiveness of postoperative progressive relaxation exercises on pain, anxiety, and physiological parameters after emergency abdominal surgery: a randomized controlled trial

Emergency abdominal surgery is associated with pronounced physiological stress, severe postoperative pain, heightened anxiety, and early autonomic dysregulation. Evidence-based non-pharmacological interventions delivered exclusively during the postoperative period remain limited in emergency surgical settings. To evaluate whether postoperative Progressive Relaxation Exercises (PRE) reduce pain and anxiety and improve physiological parameters following emergency abdominal surgery, independent of analgesic consumption. This parallel-group randomized controlled trial included 70 adults undergoing emergency abdominal surgery. Participants were randomized to receive PRE plus standard postoperative care or standard care alone. PRE was delivered individually at the bedside in three 30-min sessions during the early postoperative period. Pain, anxiety, and physiological parameters were assessed using validated instruments. Analyses were performed using analysis of covariance adjusted for baseline variables, in accordance with CONSORT 2010 guidelines. By postoperative day 2, the PRE group demonstrated significantly lower total pain scores compared with controls (mean difference –7.67, 95% CI –10.35 to –4.99; p < 0.001), with large effect sizes (Cohen’s d up to 1.51). State and trait anxiety were also significantly reduced (mean differences –7.78 and –7.52, respectively; both p = 0.004). At postoperative hour 6, PRE participants showed lower heart rate (–2.03 bpm), lower respiratory rate (–3.03 breaths/min), and higher oxygen saturation (+ 1.57%), indicating early autonomic stabilization. These physiological differences were transient and resolved by postoperative day 2. Analgesic consumption did not differ between groups. Postoperative Progressive Relaxation Exercises are a feasible, nurse-delivered intervention that significantly reduce pain and anxiety and support early physiological stabilization after emergency abdominal surgery.