Comparison of Ice Packs Application and Relaxation Therapy in Pain Reduction during Chest Tube Removal Following Cardiac Surgery

Background: Usually the chest tube removal (CTR) has been described as one of the worst experiences by patients in the intensive care unit. Aim: This study aimed to compare the effects of cold therapy and relaxation on pain of CTR among the patients undergoes coronary artery bypass graft surgery. Materials and Methods: This single-blinded clinical trial was done on 80 post-cardiac surgery patients in the heart hospital of Sari-Iran. The patients were assigned to three randomized groups that included cold therapy, relaxation, and control groups. Data analysis was done by T-test, Chi-square, generalized estimating equations and repeated measures analysis variance tests. Results: The groups had no significant differences in pain intensity before CTR (P = 0.84), but immediately after CTR there was a significant difference between the treatment (cold application and relaxation groups) and control groups (P = 0.001). There was no significant difference between relaxation and cold therapy groups. Conclusion: Regarding the relaxation and cold application methods showed relatively equal effects on reducing the pain owing to CTR. Thus, the use of relaxation because of economics, without side effects, easy to use and effective is recommended by the authors to the practitioners.

[1]  B. Karsli,et al.  Evaluation of the outcomes of ice application for the control of pain associated with chest tube irritation. , 2013, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[2]  S. Mazloum,et al.  Effect of applying ice bag on pain intensity associated with chest tube removal after cardiac surgery , 2012 .

[3]  Nurcan Ertuğ,et al.  The effect of cold application on pain due to chest tube removal. , 2012, Journal of clinical nursing.

[4]  J. Hofland,et al.  Pain management after cardiac surgery: experience with a nurse-driven pain protocol , 2012, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[5]  J. Brisswalter,et al.  Effects of Whole-Body Cryotherapy vs. Far-Infrared vs. Passive Modalities on Recovery from Exercise-Induced Muscle Damage in Highly-Trained Runners , 2011, PloS one.

[6]  Leyla Khorshid,et al.  The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: a single-blinded, randomized, double-controlled study. , 2010, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[7]  Rafiei Forough,et al.  Effect of jaw relaxation on pain intensity of burn dressing , 2010 .

[8]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[9]  M. Mackie,et al.  Early chest tube removal after coronary artery bypass graft surgery , 2009, North American journal of medical sciences.

[10]  F. Najafi,et al.  Volume Threshold for Chest Tube Removal: A Randomized Controlled Trial , 2009, Journal of injury & violence research.

[11]  P. Janwantanakul,et al.  The effect of quantity of ice and size of contact area on ice pack/skin interface temperature. , 2009, Physiotherapy.

[12]  Michael G. Miller,et al.  Comparisons of cubed ice, crushed ice, and wetted ice on intramuscular and surface temperature changes. , 2009, Journal of athletic training.

[13]  H. Esmaeili,et al.  COMPARING THE EFFECT OF COLLING GEL PADS AND ICE PACK, AFTER EPISIOTOMY, ON THE INTENSITY OD PERINAL PAIN , 2008 .

[14]  M. Bailey,et al.  The normative distribution of chest tube drainage volume after coronary artery bypass grafting. , 2007, Heart & lung : the journal of critical care.

[15]  Stacy A. Friesner,et al.  Comparison of two pain-management strategies during chest tube removal: relaxation exercise with opioids and opioids alone. , 2006, Heart & lung : the journal of critical care.

[16]  R. Howard,et al.  Chest drain removal pain and its management: a literature review. , 2006, Journal of clinical nursing.

[17]  Madhavi Singh,et al.  Topical analgesia for chest tube removal in cardiac patients. , 2005, Journal of cardiothoracic and vascular anesthesia.

[18]  M. Fox,et al.  A Randomized Comparison of Three Methods of Analgesia for Chest Drain Removal in Postcardiac Surgical Patients , 2005, Anesthesia and analgesia.

[19]  M. Layzell Improving the management of postoperative pain. , 2005, Nursing times.

[20]  E John Gallagher,et al.  Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. , 2003, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[21]  L. Daltroy,et al.  Assessment of pain, depression, and anxiety by visual analogue scale in Japanese women with rheumatoid arthritis. , 2002, Scandinavian journal of caring sciences.

[22]  J. Sauls The use of ice for pain associated with chest tube removal. , 2002, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[23]  N. Foster,et al.  Skin temperature response to cryotherapy. , 2002, Archives of physical medicine and rehabilitation.

[24]  J. Jesurum,et al.  The quick relaxation technique: effect on pain associated with chest tube removal. , 1999, Applied nursing research : ANR.

[25]  M. Cornwall,et al.  Measurement of reactive vasodilation during cold gel pack application to nontraumatized ankles. , 1992, Physical therapy.

[26]  Jeffrey L. Snedeker Cryotherapy and the Athletic Injury. , 1974 .

[27]  O G Edholm,et al.  The effect of temperature on blood flow and deep temperature in the human forearm , 1943, The Journal of physiology.