Objective: This study was conducted to examine the effect of progressive muscle relaxation exercise, cold application and local anaesthesia before chest tube removal on pain, comfort level and life findings of the patient. Material and Methods: In the sample of the controlled experimental study, 160 patients in whom a chest tube was placed in the chest surgery service of a university hospital for any reason and who met the inclusion criteria were included. In the study, three intervention groups (progressive muscle relaxation exercise, cold application and local anaesthesia) and a control group were constituted and 40 individuals were assigned to each group. Pain intensity and comfort level were measured in 5 minutes before chest tube removal, immediately after tube removal and 15 minutes after tube removal in all groups and hemodynamic indicators were recorded as well. Patient Information Form, Visual Analogue Scale (VAS), Comfort Scale and Vital Signs Monitoring Form were used to collect the data. Results: Immediately after removing the chest tube, it was found that the pain in the relaxation exercise and control group increased compared to before, the comfort decreased; the pain in the cold application and local anaesthesia group significantly decreased (p
Keywords: Chest tube; pain; comfort; cold application; progressive relaxation exercise
Amaç: Bu çalışma göğüs tüpü çıkarılması işlemi öncesinde uygulanan progresif kas gevşeme egzersizi, soğuk uygulama, lokal anestezinin hastanın ağrı, konfor düzeyi ve yaşam bulguları üzerine etkisini incelenmek amacıyla yapılmıştır. Gereç ve Yöntemler: Kontrollü deneysel nitelikteki çalışmanın örneklemine bir üniversite hastanesinin göğüs cerrahi servisinde herhangi bir nedenle göğüs tüpü yerleştirilmiş, çalışma kriterlerine uyan 160 hasta alınmıştır. Çalışmada üç müdahale (progresif kas gevşeme egzersizi grubu, soğuk uygulama grubu, lokal anestezi grubu) ve bir kontrol grubu oluşturulmuş, her bir gruba 40 birey atanmıştır. Tüm gruplarda göğüs tüpü çıkarılma işlemi başlamadan 5 dakika önce, tüp çıkarıldıktan hemen sonra ve 15 dakika sonrasında ağrı şiddeti, konfor düzeyi ölçülmüş ve hemodinamik göstergeler kaydedilmiştir. Verilerin toplanmasında Hasta Tanıtım Formu, Visüel Analog Skala (VAS), Konfor Skalası ve Yaşam Bulguları İzlem Formu kullanılmıştır. Bulgular: Göğüs tüpü çıkartıldıktan hemen sonra gevşeme egzersizi ve kontrol grubunda öncesine göre ağrının artış gösterdiği, konforun azaldığı, soğuk uygulama ve lokal anestezi grubunda ise ağrının önemli düzeyde (p
Anahtar Kelimeler: Göğüs tüpü; ağrı; konfor; soğuk uygulama; progresif gevşeme egzersizi
- Porcel JM. Chest tube drainage of the pleural space: a concise review for pulmonologists. Tuberc Respir Dis (Seoul). 2018;81(2):106-15. [Crossref] [PubMed] [PMC]
- Ring LM, Watson A. Thoracostomy tube removal: Implementation of a Multidisciplinary Procedural Pain Management Guideline. J Pediatr Health Care. 2017;31(6):671-83 [Crossref] [PubMed]
- Ertuğ N, Ulker S. The effect of cold application on pain due to chest tube removal. J Clin Nurs. 2012;21(5-6):784-90. [Crossref] [PubMed]
- 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(3):186-96. [Crossref] [PubMed]
- Friesner SA, Curry DM, Moddeman GR. Comparison of two pain-management strategies during chest tube removal; relaxation exercises with opioids and opioids alone. Heart Lung. 2006;35(4):269-76. [Crossref] [PubMed]
- Mohammadi N, Pooria A, Yarahmadi S, Tarrahi MJ, Najafizadeh H, Abbasi P, et al. Effects of cold application on chest tube removal pain in heart surgery patients. Tanaffos. 2018;17(1):29-36. [PubMed]
- Aktaş YY, Karabulut N. The use of cold therapy, music therapy and lidocaine spray for reducing pain and anxiety following chest tube removal. Complement Ther Clin Pract. 2019;34:179-84. [Crossref] [PubMed]
- Joshi VS, Chauhan S, Kiran U, Bisoi AK, Kapoor PM. Comparison of analgesic efficacy of fentanyl and sufentanil for chest tube removal after cardiac surgery. Ann Card Anaesth. 2007;10(1):42-5. [Crossref] [PubMed]
- Singh M, Gopinath R. Topical analgesia for chest tube removal in cardiac patients. J Cardiothorac Vasc Anesth. 2005;19(6):719-22. [Crossref] [PubMed]
- Glowacki D. Effective pain management and improvements in patients' outcomes and satisfaction. Crit Care Nurse. 2015;35(3):33-43; quiz 43. [Crossref] [PubMed]
- Özveren H. [Non-pharmacological methods at pain management]. Hacettepe University Faculty of Health Sciences Nursing Journal. 2011;18(1):83-92.
- Demir Dikmen Y, Yıldırım Usta Y, İnce Y, Türken Gel K, Akı Kaya M. [Determining of nurses' knowledge, behavior and clinical decision making regarding pain management]. Journal of Contemporary Medicine. 2012;2(3):162-72.
- Karabacak Ü, Acaroğlu R. Konfor kuramı. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2011;4(1):198-201.
- Hsieh LY, Chen YR, Lu MC. Efficacy of cold application on pain during chest tube removal: a randomized controlled trial: a CONSORT-compliant article. Medicine (Baltimore). 2017;96(46):e8642. [Crossref] [PubMed] [PMC]
- Mwanza E, Gwisai RD, Munemo C. Knowledge on nonpharmacological methods of pain management among nurses at Bindura Hospital, Zimbabwe. Pain Res Treat. 2019;2019:2703579. [Crossref] [PubMed] [PMC]
- Houstons S, Jesurum J. The quick relaxation techhnique: effect of pain associated with chest tube removal. Appl Nurs Res. 1999;12(4):196-205. [Crossref] [PubMed]
- Mimnaugh L, Winegar M, Mabrey Y, Davis JE. Sensations experienced during removal of tubes in acute postoperative patients. Appl Nurs Res. 1999;12(2):78-85. [Crossref] [PubMed]
- Puntillo K, Ley SJ. Appropriately timed analgesics control pain due to chest tube removal. Am J Crit Care. 2004;13(4):292-301. [Crossref] [PubMed]
- Akrofi M, Miller S, Colfar S, Corry PR, Fabri BM, Pullan MD, et al. A randomised comparison of three methods of anagesia for chest drain removal in postcardiac surgical patient. Anesth Analg. 2005;100(1):205-9. [Crossref] [PubMed]
- Valenzuela RC, Rosen DA. Topical lidocaine-prilocaine cream (EMLA) for thoracostomy tube removal. Anesth Analg. 1999;88(5):1107-8. [Crossref] [PubMed]
- Al-Otaibi RA, Mokabel FM, AL-Ghuneimy Y. The effect of cold application on pain and anxiety during chest tube removal. J Am Sci. 2013;9(7):13-23.
- 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(1):77-81. [PubMed]
- Topcu SY, Findik UY. Effect of relaxation exercises on controlling postoperative pain. Pain Manag Nurs. 2012;13(1):11-7. [Crossref] [PubMed]
- Erek Kazan E. [Cold applications and nursing care]. Hacettepe University Faculty of Health Sciences Nursing Journal. 2011;18(1):73-82.
- Ommaty R. Vademecum+ATC Index. 33. Baskı. İstanbul: Medical Tribune Yayıncılık Ltd. Şti.; 2011. p.1165.
- Gorji HM, Nesami BM, Ayyasi M, Ghafari R, Yazdani J. Comparison of ice packs application and relaxation therapy in pain reduction during chest tube removal following cardiac surgery. N Am J Med Sci. 2014;6(1):19-24. [Crossref] [PubMed] [PMC]
- Yarahmadi S, Mohammadi N, Ardalan A, Najafizadeh H, Gholami M. The combined effects of cold therapy and music therapy on pain following chest tube removal among patients with cardiac bypass surgery. Complement Ther Clin Pract. 2018;31:71-5. [Crossref] [PubMed]
- Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley 3rd JL. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5): 447-85. [Crossref] [PubMed] [PMC]
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