This study is a mixed 2 x 3 x 2 factorial model of experimental design. One hundred twenty seven patients who were scheduled to undergo a laporatomy (midline incision) at a large teaching hospital were solicited for inclusion into the study. Following consent, the patient's locus of control was determined and then randomly assigned to one of three groups of pain relief: pharmacologic (medication only), cognitive-behavioral or somatophysiologic. They were further randomly assigned to the method of pharmacologic dosing, patient controlled analgesia (PCA) or intermittent (INT) dosing. Patients assigned to the cognitive-behavioral group received positive auditory stimulation of a tape recorded message while under general anesthesia. The message suggested that their discomfort would be minimal, that they would want to participate in activities directed toward recovery, etc. Patients assigned to the somatophysiologic group had the use of a transcutaneous nerve stimulator (TENS) postoperatively. It was hypothesized the patient's pain perception, amount of analgesia utilized and complication rate would be effected by locus of control, method of administration and adjunctive pain relief modalities. Records of amounts of medication delivered on the day of surgery, postoperative days 1 & 2 were kept; at 48 hours postoperatively, patients were given a McGill's Pain Questionnaire for completion and indications of complications were noted. For the purposes of this study, complications were limited to pulmonary in nature. Pulmonary complications were identified as abnormal chest x-ray, fever of 100.5$spcirc$F or atelectasis identified by auscultation.

Results showed that neither locus of control nor method of pharmacologic administration of analgesic medication had any effect on the dependent variables when measured alone; however, when measured in combination, provided some interesting results. Internally controlled patients used less medication if receiving their analgesic medication by patient controlled analgesia. Internals placed in the somatophysiologic group (TENS) used significantly more medication with the adjunctive therapy. Internals perceived significantly less pain if receiving analgesia via PCA. Externals perceived significantly less pain in group 3 (TENS) if receiving intermittent dosing.

Interestingly, complication rate was not predicted by locus of control, method of administration of analgesia or group membership.