Aim: The present study was performed at investigating the effects of cold gel pack applied to the sternum on the pain associated with deep breathing and coughing after open-heart surgery. Materials and Methods: The study sample included 46 participants. While the study data were collected, the “Patient Information Form” prepared by the researcher based on the pertinent literature was used to question the sociodemographic characteristics of the patients, the “Visual Analogue Scale-VAS” was used to assess the severity of the patient's pain, and the “Pain Monitoring Form” was used to record the patient's pain associated with deep breathing and coughing exercises before and after cold gel pack application. Pain scores after deep breathing and coughing were measured and compared warm (room temperature) (placebo) gel pack, with (intervention) and without (control) the gel pack. Results: The intergroup analysis showed that the difference between the experimental, control and placebo groups in terms of their mean VAS scores obtained before the procedure and after the procedure was not statistically significant. But in the experimental group; in terms of their mean VAS scores obtained before the procedure and after the procedure was determined statistically significant. Conclusions: The results of this study showed that cold therapy is an effective method for management of sternal incision pain associated with coughing and deep breathing in open heart surgery patients
1.Samuels, J.G, Fetzer, S, Pain management documentation quality as a reflection of nurses clinical judgment, Journal of Nursing Care Quality, 2009, 24(3), 223-231.
2.Leegaard, M, Naden, D, Fagermoen, M.S, Postoperative pain and self-management: women’s experiences after cardiac surgery, Journal of Advanced Nursing, 2008, 63(5), 476-485.
3.Yorke, J, Mclean, B, Wallis, M, CardioThor, G.D, Cert, C, McLean, B, Cert, G, Patients’ perceptions of pain management after cardiac surgery in an australian critical care unit, Heart Lung. 2004, 33(1), 33-41.
4.Gelinas, C. Management of pain in cardiac surgery ICU patients: Have we improved over time? Intensive and Critical Care Nursing, 2007, 23(5), 298-303.
5.Boitor, M, Martorella, G, Laizner, A.M, Maheu, C, Gélinas, C. The effectiveness of hand massage on pain in critically ill patients after cardiac surgery: A randomized controlled trial protocol, JMIR Research Protocols, 2016, 5(4), e203.
6.Milgrom, L.B, Brooks, J.A, Qi, R, Bunnell, K, Wuestfeld, S, Beckman, D, Pain levels experienced with activities after cardiac surgery, American Journal of Critical Care, 2004, 13(2), 116-125.
7.Lahtinen, P, Kokki, H, Hynynen, M, Pain after cardiac surgery a prospective cohort study of 1-year incidence and intensity, Anesthesiology, 2006, 105(4), 794-800.
8.Kalso, E, Mennander, S, Tasmuth, T, Nilsson, E, Chronic poststernotomy pain, Acta Anaesthesiologica Scandinavica, 2001, 45(8), 935-939.
9.Eisenberg, E, Pultorak, Y, Pud, D, Bar-El, Y, Prevalence and characteristics of post coronary artery bypass graft surgery pain (PCP), Pain, 2001, 92(1-2), 11-17.
10. Meyerson, J, Thelin, S, Gordh, T, Karlsten, R, The incidence of chronic post-sternotomy pain after cardiac surgery: A prospective study, Acta Anaesthesiologica Scandinavica, 2001, 45(8), 940-944.
11. Bruce, J, Drury, N, Poobalan, A.S, Jeffrey, R.R, Smith, W.C, Chambers, W.A, The prevalence of chronic chest and leg pain following cardiac surgery: A historical cohort study, Pain, 2003, 104(1-2), 265-73.
12. Bjørnnes, A.K, Parry, M, Lie, I, Watt-Watson, J, Rustøen, T, Stubhaug, A, Leegaard, M, The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery, European Journal of Cardiovascular Nursing, 2017, 16(1), 18-27.
13. Gálvez, R, Marsal, C, Vidal, J, Ruiz, M, Rejas, J, Cross-sectional evaluation of patient functioning and health-related quality of life in patients with neuropathic pain under standard care conditions, European Journal of Pain, 2007, 11(3), 244-255.
14. Akkaya, T, Özkan, D, Chronic post-surgical pain, Ağrı, 2009, 21(1), 1-9.
15. Khalkhali, H, Tanha, Z.E, Feizi, A, Ardabili, S.S, Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery, Iranian Journal of Nursing and Midwifery Research, 2014, 19(6), 545-549.
16. Tetik, Ö, İslamoğlu, F, Ayan, E, Duran, M, Buket, S, Çekirdekçi, A, Intermittent infusion of 0.25% bupivacaine through an intrapleural catheter for post-thoracotomy pain relief, The Annals of Thoracic Surgery, 2004, 77(1), 284-288.
17. Bell, L, Duffy, A, Pain assessment and management in surgical nursing: A literature review, British Journal of Nursing, 2009, 18(3), 153-156.
18. Bjørnnes, A.K, Rustøen, T, Lie, I, Watt-Watson, J, Leegaard, M, Pain characteristics and analgesic intake before and following cardiac surgery, European Journal of Cardiovascular Nursing, 2016, 15(1), 47-54.
19. Chailler, M, Ellis, J, Stolarik, A, Woodend, K, Cold therapy for the management of pain associated with deep breathing and coughing post-cardiac surgery, Canadian Journal of Cardiovascular Nursing, 2010, 20(2), 18-24.
20. Ertuğ, N, Ulker, S, The effect of cold application on pain due to chest tube removal, Journal of Clinical Nursing, 2012, 21(5-6), 784- 790.
21. Nahra, H, Plaghki, L, Innocuous skin cooling modulates perception and neurophysiological correlates of brief CO2 laser stimuli in humans, European Journal of Pain, 2005, 9(5), 521-530.
22. Baxter, A.L, Cohen, L.L, McElvery, H.L, Lawson, M.L, Von Baeyer, C.L, An integration of vibration and cold relieves venipuncture pain a pediatric emergency department, Pediatric Emergency Care, 2011, 27(12), 1151-1156.
23. On, Y.A, Ağrı tedavisinde soğuk uygulamalar, Ağrı, 2006, 18(2), 5-14.
24. Kazan, E.E, Soğuk uygulamalar ve hemşirelik bakımı, Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi, 2011, 73- 82.
25. Kol, E, Erdogan, A, Karslı, B, Erbil, N. Evaluation of the outcomes of ice application for the control of pain associated with chest tube irritation. Pain Management Nursing, 2013, 14(1), 29-35.
26. Çevik, K, Zaybak, A, Açık kalp ameliyatı sonrasında yapılan egzersizlerin ağrıya etkisi, Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 2011, 14(4), 54-59.
27. Ebrahimi-Rigi, H, Feizi, A, Abdollahimohammad, A, EbrahimiRigi, Z, Salehi-Ardabili, S, Effect of cold therapy on the pain of deep-breathing and coughing in patients after coronary artery bypass grafting, Der Pharmacia Lettre, 2016, 8(10), 201-205.
28. Pishkar Mofrad, Z, Navidian, A, Ahmadabadi, C.A, Aliahmadi, E, Effects of localized cryotherapy on the severity of thoracic pain in patients undergoing coronary artery bypass grafting, MedicalSurgical Nursing Journal, 2016, 5(1), 22-27.
29. Airaksinen, O.V, Kyrklund, N, Latvala, K, Kouri, J.P, Grönblad, M, Kolari, P, Efficacy of cold gel for soft tissue injuries: A prospective randomized double-blinded trial, The American Journal of Sports Medicine, 2003, 31(5), 680-684.
30. Koç, M, Tez, M, Yoldas, Ö, Dizen, H, Göçmen, E. Cooling for the reduction of postoperative pain: Prospective randomized study, Hernia. 2006, 10(2), 184-186.
31. Chou, S.Y, Liu, H.E, Comparison of effectiveness between moist and dry cryotherapy in reducing discomfort after orthognathic surgery, Journal of Clinical Nursing, 2008, 17(13), 1735-1741.
32. Demir, Y, Khorshid, L, The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: A single- blinded, randomized, double-controlled study, Pain Management Nursing, 2010, 11(3), 186-196.
33. Payami, M.B, Daryei, N, Mousavinasab, N, Nourizade, E, Effect of cold application in combination with Indomethacin suppository on chest tube removal pain in patients undergoing open heart surgery, Iranian Journal of Nursing and Midwifery Research, 2014, 19(1), 77- 81.
34. Hasanzadeh, F, Kashouk, N.M, Amini, S, Asili, J, Emami, S.A, Vashani, H.B, Sahebkar, A, The effect of cold application and lavender oil inhalation in cardiac surgery patients undergoing chest tube removal, Excli Journal, 2016, 15, 64-74.