Effect of cold application on incisional pain associated with incentive spirometry after coronary artery bypass graft surgery

Abstract

Introduction: The use of incentive spirometry after coronary artery bypass graft surgery is accompanied by severe postoperative incisional pain. Consequently, pain reduction after cardiac surgery is considered the foremost postoperative care strategy. Various methods are administered to reduce or control pain effectively. One of these methods is cold application, which is considered a simple, cost efficient, and non-pharmacological pain relief method. Aim: This study aimed to determine the effect of cold application on incisional pain associated with incentive spirometry after coronary artery bypass graft surgery. Methods: A crossover study design was used. Sixty eligible and consenting patients were recruited. All participants were subjected to the use of incentive spirometry with and without cold gel pack application. Subjective and objective pain assessments were undertaken before and after the use of incentive spirometry with and without cold gel pack application for two consecutive days. Results: Data analysis showed significant reduction in pain scores on pain intensity and pain distress, as well as the critical care pain observation tool (P < 0.001) after the cold gel application. Univariate binary logistic regression analysis of predictive factors regarding pain intensity showed that being married, older, and having social support were protective factors against pain. Conclusions: Cold application reduces incisional pain associated with incentive spirometry in patients undergoing coronary artery bypass grafting.

Keywords

• Cold application
• Coronary artery bypass grafting patients
• Crossover study design
• Incentive spirometry
• Incisional pain
• Procedural pain