Effect of Cryotherapy on Pain Associated with Chest Tube Removal after Thoracotomy

Abstract

Context: Chest tube removal (CTR) is described as one of the worst feelings for critically ill patients after thoracotomy. Unrelieved pain causes undesired consequences that have adverse effects on patient quality of care. Analgesics usually manages CTR pain, but patients respond differently to drugs and might not provide complete relaxation. Cryotherapy is commonly applied as a non-pharmacological intervention for relieving CTR pain.

Aim: This study aimed to evaluate the effect of cryotherapy on pain associated with chest tube removal after thoracotomy.

Methods: This study was conducted in the cardio-thoracic critical care units at Cardiovascular and Thoracic Academy, affiliated to Ain Sham University Hospital. A purposive sample of 140 patients undergoing thoracotomy was included in this study. They were divided into control and study group (70 patients in each group). Data were obtained using the Chamber-Price Modified Pain Rating Scale (CPPRS), Standardized Linear Scale for Pain Assessment, and Modified McGill Pain Questionnaire-Short Form (MPQ-SF).

Results: The results reveal that 50%, 67.1% of the control and study group patients were in the age group 51-≥60 years. 62.9, 81.4% of the control and study group were males. Besides, there were highly statistically significant differences regarding peripheral pulse, apical pulse, and respiratory rate throughout CTR pain assessment times and a highly statistically significant difference regarding blood pressure immediately after CTR between the study and control groups. Also, statistically significant differences regarding physiological and behavioral parameters, pain intensity, and quality (sensory and affective descriptors) were found between the study and control groups immediately and 30 minutes after cryotherapy was applied after chest tube removal.

Conclusion: Cryotherapy effectively improved hemodynamic, physiological, and behavioral parameters, relieving pain intensity and improving pain quality after chest tube removal for patients with thoracotomy. The current study recommends conducting periodic in-service educational programs for critical care nurses regarding the benefits, methods, contraindications, and side effects of cryotherapy for relieving pain associated with CTR after thoracotomy. Motivate nurses in critical care units to use cryotherapy as a non-pharmacological therapy for relieving pain associated with chest tube removal.