The effects of cold compress and transcutaneous electrical nerve stimulation on the pain associated with chest tube removal among patients with coronary bypass grafting

The effects of virtual reality on pain, anxiety, and comfort during the chest tube removal procedure: A randomized clinical trial

PURPOSE

The purpose of the current study is to determine the effects of virtual reality on pain, anxiety, and comfort during chest tube removal.

MATERIALS AND METHODS

The research was conducted in the Cardiovascular Surgery Department of Atatürk University Health Practice and Research Hospital between January 2023 and April 2024. The study was performed as a randomized controlled experimental trial with a pretest-posttest control group. Eighty-two patients (41 in the intervention group and 41 in the control group) were included in the research. Patients in the intervention group watched a video with virtual reality glasses during chest tube removal. The "Descriptive Information Form," "Visual Analog Scale," "Verbal Pain Scale," "State Anxiety Inventory," and "Comfort Scale" were used to collect data. Number, percentage, mean, standard deviation, chi-square, paired sample t-test, independent sample t-test, Mann-Whitney U test, Wilcoxon test, and linear regression analysis were used in data evaluation. Our study was recorded in the Clinical Trials database with protocol number "NCT06550323."

RESULTS

The groups had similar descriptive characteristics (p > 0.05). The pre-procedural mean pain, anxiety, and comfort scores were similar in the two groups (p > 0.05). The post-procedural mean VAS and verbal pain scores, mean anxiety, and comfort scores of the intervention group were lower in comparison with the control group (p < 0.05).

CONCLUSION

The research findings showed that virtual reality significantly reduced pain and anxiety while increasing comfort levels during chest tube removal. Therefore, it is recommended that virtual reality be used during chest tube removal.

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.