The Effect of Rhythmic Breathing on the Severity of Sternotomy Pain after Coronary Artery Bypass Graft Surgery: A Randomized Controlled Clinical Trial

Abstract

Background. Moderate-to-severe pain is reported in up to 75% of the patients in the first 48 hours after cardiac surgery. Evidence suggests that distraction is an effective nursing intervention for controlling short-term and transient pain. Distraction can be achieved by various techniques, including progressive muscle relaxation, meditation, and rhythmic breathing (RB). The present research aimed at evaluating the impacts of RB on the severity of sternotomy pain after Coronary Artery Bypass Graft (CABG). Methods. This randomized, controlled clinical trial was conducted on 60 patients after CABG surgery at the open-heart surgery Intensive Care Unit (ICU) of Kowsar Hospital, affiliated to Semnan University of Medical Sciences in Semnan, Iran. The patients were selected through convenience sampling and randomly assigned to two groups, including (1) intervention or RB and (2) control groups. RB was performed in the intervention group every 12 hours (9 a.m. and 9 p.m.) for three consecutive days after the surgery. The control group received only routine care for pain control (opioid analgesics) with no additional interventions. The severity of pain was measured every day in both groups of patients before and after the interventions using the Visual Analog Scale (VAS). Results. The mean postintervention pain scores were significantly different from the mean preintervention scores in the intervention group ( p < 0.05). The changes in the mean pain score in the intervention group were also significantly different from the corresponding changes in the controls ( p < 0.05). Conclusion. Based on the results, the severity of pain after the intervention was significantly lower in the RB group compared to the control. RB was found to be an effective technique for reducing the patients’ pain and is therefore recommended as a post-CABG pain control technique. Iranian Registry of Clinical Trials: this trial is clinically registered with IRCT20120109008665N7, registered 3 September 2018.

The Effect of Listening to Holy Quran Recital on Pain and Length of Stay Post-CABG: A Randomized Control Trial

“…Open-heart surgery is currently carried out in industrialized and developing nations to extend patient lives and enhance the quality of life [ 1 , 2 ]. The most frequent open-heart procedure is a coronary artery bypass graft (CABG) [ 2 , 3 ] which accounts for around 60% of all cardiac operations [ 2 ].…”

“…Open-heart surgery is currently carried out in industrialized and developing nations to extend patient lives and enhance the quality of life [ 1 , 2 ]. The most frequent open-heart procedure is a coronary artery bypass graft (CABG) [ 2 , 3 ] which accounts for around 60% of all cardiac operations [ 2 ]. Heart surgery, despite being a successful cardiac treatment, is nevertheless a traumatic procedure that can result in a variety of side effects, such as excruciating pain at the surgical site, stroke, pulmonary edema, pericarditis, and postoperative depression [ 2 , 4 , 5 ].…”

“…The most frequent open-heart procedure is a coronary artery bypass graft (CABG) [ 2 , 3 ] which accounts for around 60% of all cardiac operations [ 2 ]. Heart surgery, despite being a successful cardiac treatment, is nevertheless a traumatic procedure that can result in a variety of side effects, such as excruciating pain at the surgical site, stroke, pulmonary edema, pericarditis, and postoperative depression [ 2 , 4 , 5 ]. For this reason, patients are transferred to the intensive care unit (ICU) following CABG surgery and are monitored using a variety of medical devices, including electrocardiogram monitors, arterial and central lines, ventilators, and chest tubes.…”

“…It has been reported that up to 75% of patients complain of moderate to severe pain in the first 48 hours post-CABG [ 2 , 6 ]. The sternotomy, saphenous vein, and internal thoracic artery harvesting, as well as the insertion of numerous drains, are some of the variables that lead to pain after CABG surgery [ 7 ].…”

“…Pain management strategies fall under two major umbrellas: pharmacological (medicinal) and nonpharmacological (nonmedicinal) [ 2 ]. Medications like opioids are currently utilized to manage pain in cardiac patients, but their prices and side effects on many body systems and organs, which raise patient mortality and morbidity, make them undesirable as the first line of treatment [ 2 , 16 ].…”