Comparison of two pain-management strategies during chest tube removal: relaxation exercise with opioids and opioids alone.

Purpose: The purpose of this study was to determine whether the use of a slow deep-breathing relaxation exercise, when used as an adjunct to opioid analgesia, decreases pain during chest tube removal (CTR) after coronary bypass surgery.

Design: A two-group quasi-experimental pretest/posttest design was used.

Sample: A convenience sample of 40 adults who had undergone coronary artery bypass graft surgery and met all inclusion criteria were recruited before CTR.

Setting: Data were collected in the Cardiothoracic Surgical Intensive Care Units of three acute care facilities in the Midwestern United States.

Method: A 10-cm vertical Visual Analog Scale was used to measure pain at three points: before CTR, immediately after CTR, and 15 minutes after CTR. The experimental group received slow breathing relaxation exercises in addition to the usual opioid doses administered.

Findings: Data were analyzed using analysis of variance, and multivariate analysis of covariance yielded a significant difference in pain ratings immediately after CTR and 15 minutes after CTR for the group receiving relaxation exercise as an adjunct to opioid analgesic.

Conclusions: This study supports the use of a slow deep-breathing relaxation exercise as an adjunct to the use of opioids for pain management during CTR among patients who have undergone coronary bypass surgery.