School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Critical Care Nursing, Nursing and Midwifery Faculty, Centre for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran.
Complement Ther Clin Pract. 2018 May;31:71-75. doi: 10.1016/j.ctcp.2018.01.006. Epub 2018 Feb 6.
Chest tube removal is an extremely painful procedure and patients may not respond well to palliative therapies. This study aimed to examine the effect of cold and music therapy individually, as well as a combination of these interventions on reducing pain following chest tube removal.
A factorial randomized-controlled clinical trial was performed on 180 patients who underwent cardiac surgery. Patients were randomized into four groups of 45. Group A used ice packs for 20 minutes prior to chest tube removal. Group B was assigned to listen to music for a total length of 30 minutes which started 15 minutes prior to chest tube removal. Group C received a combination of both interventions; and Group D received no interventions. Pain intensity was measured in each group every 15 minutes for a total of 3 readings. Analysis of variance, Tukey and Bonferroni post hoc tests, as well as repeated measures ANOVA were employed for data analysis.
Cold therapy and combined method intervention effectively reduced the pain caused by chest tube removal (P < 0.001). Additionally, there were no statistically significant difference in pain intensity scores between groups at 15 minutes following chest tube removal (P = 0.07).
Cold and music therapy can be used by nursing staff in clinical practice as a combined approach to provide effective pain control following chest tube removal.
胸腔引流管的移除是一个极其痛苦的过程，患者可能对姑息治疗反应不佳。本研究旨在单独评估冷疗和音乐疗法，以及这两种干预措施联合应用对减轻胸腔引流管移除后疼痛的效果。
对 180 名接受心脏手术的患者进行了一项析因随机对照临床试验。患者随机分为 4 组，每组 45 例。A 组在移除胸腔引流管前使用冰袋 20 分钟。B 组被分配在移除胸腔引流管前 15 分钟开始聆听音乐 30 分钟。C 组接受两种干预措施的联合；D 组不接受任何干预。在每个组中，每 15 分钟测量一次疼痛强度，共测量 3 次。采用方差分析、Tukey 和 Bonferroni 事后检验以及重复测量方差分析进行数据分析。
冷疗和联合方法干预有效地减轻了胸腔引流管移除引起的疼痛（P<0.001）。此外，在移除胸腔引流管后 15 分钟，各组之间的疼痛强度评分没有统计学上的显著差异（P=0.07）。
冷疗和音乐疗法可被护理人员在临床实践中联合应用，以提供有效的疼痛控制，减轻胸腔引流管移除后的疼痛。
