Effects of Cold Application on Chest Tube Removal Pain in Heart Surgery Patients

Document Type : Original Article


1 Department of Critical Care Nursing, Nursing and Midwifery Faculty, Centre for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran

2 Department of Cardiac Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran

4 Department of Bio-statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

5 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: Chest tube removal is considered a painful technique, which may not respond well to palliative therapies. There are no standard procedures or guidelines to manage the pain associated with chest tube removal. This study aimed to examine the effects of cold application on pain reduction during and after chest tube removal.
Materials and Methods: This randomized controlled trial was conducted on 90 hospitalized patients, undergoing heart bypass surgery at the intensive care units where at least a pleural chest tube was inserted. The patients were randomly divided into two groups (45 samples per group). In the cold application group, an ice bag was placed at the designated point for 20 minutes before chest tube removal, while only routine interventions were applied for chest tube removal in the control group. Pain severity was measured in the groups before, during, and 15 minutes after chest tube removal, using the visual analogue scale. Repeated measures ANOVA test was applied for data analysis.
Results: There was no significant difference in the baseline pain score between the groups (P= 0.18). However, there was a significant difference in terms of pain severity score between the cold application (3.58±1.09) and control (4.73±0.86) groups during chest tube removal (p < 0.001). On the other hand, there was no significant difference between the groups regarding the score of pain severity at 15 minutes after chest tube removal (P= 0.38).
Conclusion: Cold application, as a nonpharmacological intervention, may contribute to the alleviation of cryotherapy-related pain.