Combined effects of reflexology massage and respiratory relaxation on pain following chest tube removal in heart surgery patients
Strong EvidenceIn Plain Language: reflexology, explained
Removing the chest tube in cardiac patients after surgery is one of the worst experiences of hospitalization in the intensive care units. Various pharmacological and non-pharmacological methods are available to control pain in these patients. This study aimed to investigate the combined effect of reflexology massage and respiratory relaxation on pain following chest tube removal in cardiac surgery patients of Shahid Beheshti Hospital in Shiraz, Iran, in 2023. This was a double-blind randomized clinical trial performed on 140 patients who underwent heart surgery and had a chest tube in Shiraz, Iran. The samples were randomly divided into four groups: 1- control group, 2- respiratory relaxation group, 3- foot reflex massage group, and 4- a combination of respiratory relaxation and reflexology massage. To collect data, two demographic questionnaires, and a visual analog scale were used. The participants of the four groups were not meaningfully different in terms of age, BMI, duration of surgical operation, gender, job, education, place of residency, number of chest tubes, history of operation (P = 0.99, 0.31, 0.06, 0.81, 0.97, 0.96, 0.17, 0.10, 0.89 respectively). The mean scores of pain intensity during chest tube removal, and 15 min after chest tube removal were not statistically different among the four groups of study (P = 0.15, 0.54 respectively); However, just after chest tube removal, the mean scores of pain intensity differed meaningfully among four groups (P = 0.008). The results showed that reflexology massage and respiratory relaxation both reduce pain immediately after chest tube removal in heart surgery patients. Also, the combination of these two techniques was more effective in reducing patients' average pain.
Key Findings: what this randomised trial found
- ✓The study compared four intervention groups (control, respiratory relaxation alone, foot reflexology alone, and combined reflexology with respiratory relaxation) to evaluate pain management after chest tube removal in cardiac surgery patients.
- ✓A double-blind randomized clinical trial design was used with 140 heart surgery patients in Shiraz, Iran, with pain measured using a visual analog scale.
- ✓Baseline demographic characteristics including age and BMI were comparable across the four study groups, establishing appropriate group matching for the intervention comparison.
What This Means for You
If you're facing chest tube removal after heart surgery, reflexology combined with breathing exercises may provide some pain relief in the immediate moment, though the evidence from this study is not conclusive enough to guarantee effectiveness.
What This Means for Practitioners
Combining reflexology with respiratory relaxation techniques may have potential for acute pain management in cardiac patients during chest tube removal, warranting further investigation with larger sample sizes and refined protocols.
Study Design: how this randomised trial was run
Common questions about this study
What does this study mean in practice?
If you're facing chest tube removal after heart surgery, reflexology combined with breathing exercises may provide some pain relief in the immediate moment, though the evidence from this study is not conclusive enough to guarantee effectiveness.
What did this study find?
The study compared four intervention groups (control, respiratory relaxation alone, foot reflexology alone, and combined reflexology with respiratory relaxation) to evaluate pain management after chest tube removal in cardiac surgery patients. A double-blind randomized clinical trial design was used with 140 heart surgery patients in Shiraz, Iran, with pain measured using a visual analog scale. Baseline demographic characteristics including age and BMI were comparable across the four study groups, establishing appropriate group matching for the intervention comparison.
How strong is this evidence?
This is a randomised trial and we rate its evidence strong. It covers 140 participants. It was published in Journal of cardiothoracic surgery. Reflexology is a complementary therapy, not a replacement for medical treatment.
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