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

BACKGROUND AND AIM

Chest tube removal (CTR) can cause severe acute pain which is usually described by patients as a painful experience. This study compared the effects of cold compress, transcutaneous electrical nerve stimulation (TENS), and combined cold compress-TENS on CTR-associated pain among patients with coronary artery bypass grafting (CABG).

METHODS

This randomized controlled trial was conducted in 2018-2019 using a double-blind four-group design. Participants were 120 patients with CABG selected from Shafa hospital, Kerman, Iran, and randomly allocated to a cold compress, a TENS, a combined cold compress-TENS, and a placebo group (compress with room temperature) and TENS with an off TENS device. Each participant received the intervention for 15 min immediately before CTR. CTR-associated pain was assessed before, during, immediately after, and 15 min after CTR. Data were analyzed using the SPSS program (v. 22.0) at a significance level of less than 0.05.

RESULTS

The data of 29 participants in the placebo group, 26 in the TENS group, 30 in the cold compress group, and 26 in the combined cold compress-TENS group was gathered. Baseline demographic and clinical characteristics and pain intensity scores of participants had no statistically significant differences among all four groups (P > 0.05). The mean score of pain intensity in all groups was at its highest level during CTR and gradually decreased afterwards, but this pain intensity reduction in the compress-TENS group was significantly greater than other groups (P < 0.001).

CONCLUSION

Combined cold compress-TENS is more effective than separate cold compress and TENS in reducing CTR-associated pain among patients with CABG. Therefore, non-pharmacological methods such as combined cold compress-TENS are recommended for managing CTR-associated pain.

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

The process of removal of a chest tube can cause pain and anxiety. Spiritual care can be considered as a component of nursing care, especially in the pain and anxiety relating to such procedures. This study was a randomized clinical trial. Eighty patients completed the study. The findings showed significant differences in anxiety and pain between groups (p = 0.001). Spiritual care reduced anxiety and pain caused by chest tube removal in patients (Shia and Sunni Islam) undergoing heart surgery.