The Impact of Using Ice on Quality of Pain Associated with Chest Drain Removal in Postcardiac Surgery Patients: An Evidence-Based Care

Abstract

Background: Patients undergoing cardiothoracic surgery require the placement of at least one chest drain. Chest Drain Removal (CDR) has been considered to be a painful event in patient’s postoperative recuperation. Objective: This study aimed to evaluate the impact of using ice on quality of pain associated with CDR in adult patients undergoing cardiac surgery Materials and Methods: This randomized, observer-blind, crossover trial was done on 51 post-cardiac surgery patients who had two chest drains in the Mashhad Heart Center in Iran. The patients were assigned to ice, placebo, and control groups. Ice and placebo bags were used over the region around the chest drains for 20 minutes prior to CDR. The quality of pain was assessed via Short-Form McGill Pain Questionnaire (SF-MPQ) before and after CRT. The data were analyzed through the SPSS software using ANOVA, Kruskal-Wallis, and Chi-square tests. Results: The study findings revealed that the three groups were not significantly different regarding pain quality before CDR (p=0.24). However, the ice bag group (4.6±4.4) was significantly different from the placebo (8.1±6.9) and control groups (7.1±5.3) concerning the pain quality score immediately after CDR (p<0.05). The results of chi-square test also showed that the three groups were significantly different regarding “hot-burning” (p=0.009). However, no significant differences were observed with regard to other items of SF-MPQ. Conclusion: The results indicated that ice bag application could be used as an effective, safe, and inexpensive non-pharmacological intervention to reduce patients’ pain and increase their comfort during CDR.

Effect of Spiritual Care on Chest Tube Removal Anxiety and Pain in Heart Surgery in Muslim Patients (Shia and Sunni)

“…This is because this tube activates the tapes adhering to the skin, somatic and visceral fibers due to adhesion to surrounding tissues during removal (Mokadem et al., 2017). This finding is in line with the results of other researchers (Ayyasi et al., 2019; Demir & Khorshıd, 2010; Mazloum et al., 2018). In addition, the least pain severity (mild pain) was reported in both groups at the stage prior to chest tube removal.…”

“…Excessive anxiety delays recovery from disease, and patients with anxiety are likely to be more affected by further problems such as arrhythmia; also, the probability of death is higher in the first months after surgery (Momeni et al., 2013). Patients who undergo open heart surgery require at least one chest tube in order to facilitate lung expansion and excretion of secretions (Mazloum et al., 2018). Typically, the chest tube is removed 24 to 48 hours after heart surgery when the volume of secretions at 24 hours leads to a discharge lesser than 100–150 cc and the patient’s breathing sounds are normal (Ayyasi et al., 2019; Mazloum et al., 2018).…”

“…Patients who undergo open heart surgery require at least one chest tube in order to facilitate lung expansion and excretion of secretions (Mazloum et al., 2018). Typically, the chest tube is removed 24 to 48 hours after heart surgery when the volume of secretions at 24 hours leads to a discharge lesser than 100–150 cc and the patient’s breathing sounds are normal (Ayyasi et al., 2019; Mazloum et al., 2018). The process of removal of the chest tube can cause a severe and transient pain which is usually considered as one of the worst and most severe experiences for patients undergoing surgery (Mazloum et al., 2018; Mokadem et al., 2017).…”

“…Typical sedatives include narcotics and non-steroidal anti-inflammatory drugs (NSAIDs); however, despite their efficacy, these medications may have numerous side effects such as pulmonary problems, hemodynamic changes, nausea, vomiting, urinary retention, itching, and gastrointestinal (GI) bleeding (Ayyasi et al., 2019). Nowadays, the tendency for the use of non-pharmacological methods to relieve pain and anxiety is growing (Bastani et al., 2012; Hatami et al., 2018; Mazloum et al., 2018). One of these methods is the use of spiritual care for relieving anxiety and pain in patients (Momeni et al., 2013; Soltani et al., 2017; Tajbakhsh et al., 2016).…”

The effect of cold application on pain during the chest tube removal: A meta-analysis

“…Removal of the drains leads to adhesion rupture and stimulation of the parietal pleura and pectoral muscles followed by the release of neurotransmitters and stimulation of pain receptors, eventually resulting in acute pain. [2,3] Chest tube removal (CTR) is a painful, distressful procedure and frightening experience described by patients to be among the most unpleasant feelings. Therefore, it should be managed with as little pain and distress as possible.…”