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Research Article| Volume 55, P102-107, September 2022

The effect of cold application on pain in patients with chest tubes before deep breathing and coughing exercises: A randomized controlled study

      Highlights

      • The effect of cold therapy on pain due to removal of chest tubes has been explored.
      • Research on using cold therapy with deep breathing and coughing exercises is limited.
      • Cold therapy before deep breathing and coughing exercises relieves pain.

      Abstract

      Background

      Pain control is very important to ensure the comfort of patients and increase their quality of life.

      Objectives

      The purpose of this randomized controlled trial was to examine the effects of cold therapy in patients with chest tube before deep breathing and coughing exercises.

      Methods

      The study participants were patients with chest tubes, who were treated at a training and research hospital in Turkey between May 2, 2017, and October 24, 2019. Seventy patients participated in the study in accordance with the inclusion criteria. The intervention group, patient identification form, and visual analogue scale were used to collect data. Cold therapy was applied for the intervention group before deep breathing and coughing exercises, and not for the control group.

      Results

      The pain rates of the intervention group participants were lower (3.31) after the deep breathing and coughing exercises, than the rates (4.24) before the exercises (p<0.01). The pain rate (5.29) among the control group participants after the deep breathing and coughing exercises was significantly higher than those before (3.47) the exercises (p<0.01).

      Conclusions

      The study revealed that cold therapy before deep breathing and coughing exercises effectively relieves pain in patients with chest tubes.

      Keywords

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      References

        • Mathur PN.
        Therapeutic local procedures: chest tubes and therapeutic thoracentesis.
        Eur Respir Mon. 2002; 22: 297-310
        • Bruce EA
        • Howard RF
        • Franck LS.
        Chest drain removal pain and its management: a literature review.
        J Clin Nurs. 2006; 15: 145-154https://doi.org/10.1111/j.1365-2702.2006.01273.x
        • Kol E
        • Erdoğan A
        • Karslı B.
        Nature and intensity of the pain following thoracotomy.
        Int J Nurs Pract. 2012; 18: 84-90https://doi.org/10.1111/j.1440-172X.2011.01999.x
        • Brims F
        • Davies H
        • Lee G.
        Respiratory chest pain: diagnosis and treatment.
        Med Clin North Am. 2010; 94 (Mar): 217-232https://doi.org/10.1016/j.mcna.2010.01.003
        • Fiorelli A
        • Morgillo F
        • Milione R
        • Pace MC
        • Passavanti MB
        • Laperuta P
        • Aurilio Santini M
        Control of postthoracotomy pain by transcutaneous electrical nerve stimulation: effect on serum cytokine levels, visual analogue scale. Pulmonary Function and Medication.
        Eur J Cardiothorac Surg. 2012; 40: 861-868https://doi.org/10.1093/ejcts/ezr108
        • Asida SM
        • İA Youssef
        • Mohamad AK
        • Abdelrazik AN
        Post-thoracotomy pain relief: thoracic paravertebral block compared with systemic opioids.
        Egypt J Anaesthesia. 2012; 28: 55-60https://doi.org/10.1016/j.egja.2011.10.004
        • Fiorelli A
        • Morgillo F
        • Milione R
        • Pace MC
        • Passavanti MB
        • Laperuta P
        • Aurilio Santini M
        Control of postthoracotomy pain by transcutaneous electrical nerve stimulation: Effect on serum cytokine levels, visual analogue scale. Pulmonary Function and Medication.
        Eur J Cardiothorac Surg. 2012; 40: 861-868https://doi.org/10.1093/ejcts/ezr108
        • Rock P
        • Preston BR.
        Postoperative pulmonary complications.
        Curr Opin Anaesthesiol. 2003; 16: 123-132https://doi.org/10.1097/00001503-200304000-00004
        • N Carol R.Taylor
        • Lillis Carol
        • LeMone Priscilla
        • Lynn Pamela
        • Marilee LeBon BA.
        Fundamentals of Nursing.
        7th Ed. 2010
        • Willens JS.
        Pain management.
        in: Smeltzer SC Bare BG Brunner & Suddarth's Textbook of Medical Surgical Nursing. 10th ed. Lippincott Williams & Wilkins, Philadelphia2006: 216-248
        • Puntillo K
        • Ley SJ.
        Appropriately timed analgesics control pain due to chest tube removal.
        Am J Crit Care. 2004; 13: 292-301
        • Koç M
        • Tez M
        • Yoldaş O
        • Dizen H
        • Göçmen E.
        Cooling for the reduction of postoperative pain: prospective randomized study.
        Hernia. 2006; 10: 184-186https://doi.org/10.1007/s10029-005-0062-2
        • Adie S
        • Kwan A
        • Naylor JM
        • Harris IA
        • Mittal R.
        Cryotherapy following total knee replacement.
        Cochrane Database Systemat Rev. 2012; (Art. No.: CD007911)
        • Kol E
        • Erdogan A
        • Karslı B
        • Erbil N.
        Evaluation of the outcomes of ıce application for the control of pain associated with chest tube ırritation.
        Pain Manag Nurs. 2013; 14: 29-35https://doi.org/10.1016/j.pmn.2010.05.001
        • Watkins AA
        • Johnson TV
        • Shrewsberry AB
        • Nourparvar P
        • Madni T
        • Watkins CJ
        • Master V.A.
        Ice Packs reduce postoperative midline ıncision pain and narcotic use: a randomized controlled trial.
        J Am Coll Surg. 2014; 219: 511-517https://doi.org/10.1016/j.jamcollsurg.2014.03.057
        • Demir Y
        • Khorshid L.
        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.
        Pain Manag Nurs. 2010; 11: 186-196https://doi.org/10.1016/j.pmn.2009.09.002
        • Sauls J.
        The use of ice for pain associated with chest tube removal.
        Pain Manag Nurse. 2002; 3: 44-52https://doi.org/10.1053/jpmn.2002.123017
        • Gorji H
        • Nesami H
        • Ayvasi M
        • Ghafari R
        • Yazdani J.
        Comparison of ice packs application and relaxation therapy in pain reduction during chest tube removal following cardiac surgery.
        North Am J Med Sci. 2014; 6: 19-24https://doi.org/10.4103/1947-2714.125857
        • Mohammadi N
        • Pooria A
        • Yarahmadi S
        • Tarrahi MJ
        • Najafizadeh H
        • Abbasi P
        • Moradi B.
        Effects of Cold Application on Chest Tube Removal Pain in Heart Surgery Patients. 17. National Research Institute of Tuberculosis and Lung Disease, 2018: 29-36 (PMCID: PMC6087532)
        • Mokadem NM
        • Ibraheem SS.
        Cold application and breathing exercises to reduce pain and anxiety during chest tube removal.
        Am J Nurs. 2017; 6: 285-292https://doi.org/10.11648/j.ajns.20170604.12
        • Sinha VR
        • Dave K
        • Goyal H
        • Mathur G.
        Effects of cold apaplication on pain & anxiety during chest tube removal among post operative cardiac surgery adult patients.
        J Nurs Health Sci. 2015; 4: 64-68https://doi.org/10.9790/1959-04626468
        • Ülker S
        • Ertuğ N.
        The effect of cold appliccation on pain due to chest tube removal.
        J Clin Nurs. 2011; 21: 784-790https://doi.org/10.1111/j.1365-2702.2011.03955.x
        • Hsieh L
        • Chen YR
        • Chun Lu M
        Efficacy of cold application on pain during chest tube removal: A randomized controlled trial.
        Medicine (Baltimore). 2017; : 96https://doi.org/10.1097/MD.0000000000008642
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.
        Ann Intern Med. 2009; 151: 264-269https://doi.org/10.7326/0003-4819-151-4-200908180-00135
        • Wewers M.E.
        • Lowe N.K.
        A critical review of visual analogue scales in the measurement of clinical phenomena.
        Res Nurs Health. 1990; 13: 227-236
        • Alaca N.
        • Kablan N.
        Acute effects of cold pack for different periods on the biomechanical properties of the rectus femoris muscle.
        Altern Ther Health Med. 2021; 27: 92-99
        • Mac Auly DC
        Ice therapy: how good is the evidence?.
        Int J Sports Med. 2001; 22: 379-384https://doi.org/10.1055/s-2001-15656
        • Zencir G
        • Eser İ.
        Effects of cold therapy on pain and breathing exercises among median sternotomy patients.
        Pain Manag Nurs. 2016; 17: 401-410https://doi.org/10.1016/j.pmn.2016.05.006
        • Payami MB
        • Daryei N
        • Mousavinasab N
        • Nourizade E.
        Effect of cold application in combination with Indomethacin suppository on chest tube removal pain in patients undergoing open heart surgery.
        Iran J Nurs Midwifery Res. 2014; 19 (PMCID: PMC3917189): 77-81
        • Vaishali RS
        • Koushal D
        • Goyal Harinderjeet
        • Mathur RG
        Effects of cold application on pain & anxiety during chest tube removal among post operative cardiac surgery adult patients.
        J Nurs Health Sci. 2015; 4: 64-68
        • Khalkhali H
        • Tanha ZER
        • Feizi A
        • Ardabili SS.
        Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery.
        Iranian J Nurs Midwifery Res. 2014; 19 (PMCID: PMC4280715): 545-549
        • Kunter D.
        The effect of cold application before breathing exercises on sternotomy pain: a quasi-experimental study.
        Adnan Menderes Univ Health Sci J. 2019; 5: 1776-1787https://doi.org/10.30569/adiyamansaglik.623953
        • Rigi HE
        • Feizi A
        • Abdollahimohammad A.
        Effect of coldt herapy on the pain of deep-breathig and coughing in patients after coronary artery bypass grafting.
        Der Pharmacia Lettre. 2016; 8: 201-205
        • Yılmaz HE.
        The Effect of Cold Application on Pain Caused by Mediastinal and Thoracic Tube Removal in Patients After Open Cardiovascular Surgery.
        Acı Badem University, Istanbul2017 (Master Thesis)
        • Acevedo A
        • Leo´n J.
        Ambulatory hernia surgery under local anesthesia is feasible and safe in obese patients.
        Hernia. 2010; 14: 57-62
        • Panni MK
        • Columb MO.
        Obese parturients have lower epidural local anaesthetic requirements for analgesia in labour.
        Br J Anaesth. 2006; 96: 106-110
        • Schroeder K
        • Andrei AC
        • Furlong MJ
        • et al.
        The perioperative effect of increased body mass index on peripheral nerve blockade: an analysis of 528 ultrasound guided interscalene blocks.
        Rev Bras Anestesiol. 2012; 62: 28-38