Application of Complementary and Alternative Medicine Therapy on Patient with Postoperative Pain After Cardiac Surgery: a Literature Review
Abstract
Pain is a devastating outcome following cardiac surgery due to routine procedures, including chest tube removal, deep breathing, and coughing exercise. Pharmacological treatment requires complementary interventions in addressing the post-acute pain phase. This study aimed to identify the application of complementary and alternative medicine (CAM) to reduce postoperative pain after cardiac surgery. A literature search was conducted by exploring original studies on the Google Scholar, PubMed NCBI, ProQuest, and ScienceDirect database that published in the last five years (2016-2021), enrolled adult participants who were undergoing cardiac surgery, and evaluated the outcome of CAM therapy on the postoperative pain after the cardiac surgery. Eighteen original studies were analyzed and synthesized. Thirteen studies employed randomized controlled trial, four studies applied quasi-experimental, and one study used one group pre-post-test design. Among these studies, ten studies focused on the manipulative and body-based practices domain (cryotherapy and massage). The application of relaxation exercise, music therapy, and distraction technique from the mind-body intervention domain was discussed in six studies. Only three studies reported the utilization of therapy from the alternative medical system, biologically-based therapy, and energy therapy domain. The majority of the CAM interventions provided significant effects in postoperative pain relief after cardiac surgery. Nurses should be able to assign appropriate CAM therapies for each patient, although all domains of CAM consider as an effective modality for postoperative pain relief after cardiac surgery. Hence, the CAM therapy would be a proper complement for the pharmacological therapies, effective in reducing the pain, and provides a chance for the patient to manage their pain independently.
References
Bardia, A., Barton, D.L., Prokop, L.J., Bauer, B.A., Moynihan, T.J., 2006. Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 24(34), pp. 5457–5464. https://doi.org/10.1200/JCO.2006.08.3725
Bastani, F., Hajizadeh, S., Sa`atchi, K., Haghani, H., 2016. Comparing the Effect of Acupressure and Cryotherapy on the Pain Caused by Removal of Chest Drain Tube in the Elderly Patients Undergoing Open Heart Surgery. J. Client-Centered Nurs. Care 2(1), pp. 37–52. https://doi.org/10.32598/jccnc.2.1.37
Black, C.D., Herring, M.P., Hurley, D.J., O’Connor, P.J., 2010. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J. Pain. 11(9), pp. 894–903. https://doi.org/10.1016/j.jpain.2009.12.013
Chandrababu, R., Nayak, B.S., Pai, V.B., Patil, N.T., George, A., George, L.S., Devi, E.S., 2017. Effect of Complementary Therapies in Patients Following Cardiac Surgery: A Narrative Review. Holist. Nurs. Pract. 31 (5), pp. 315–324. https://doi.org/10.1097/HNP.0000000000000226
Chen, Y.-W., Wang, H.-H., 2014. The effectiveness of acupressure on relieving pain: a systematic review. Pain Manag. Nurs. 15(2), pp. 539–550. https://doi.org/10.1016/j.pmn.2012.12.005
Cogan, J., 2010. Pain management after cardiac surgery. Semin. Cardiothorac. Vasc. Anesth. 14(3), pp 201–204. https://doi.org/10.1177/1089253210378401
Ebrahimi-Rigi, H., Feizi, A., Abdollahimohammad, A., Ebrahimi-Rigi, Z., Salehi-Ardabili, S., 2016. Effect of cold therapy on the pain of deep-breathing and coughing in patients after coronary artery bypass grafting. Pharm. Lett. 8(10), pp. 201–205.
El-Naggar, M.M.M., Zahra, A.I., Kanona, A., El-Sheikh, A.A., 2020. Effect of cold gel pack on controlling pain intensity associated with deep breathing and coughing exercise after cardiac surgery. IOSR J. Nurs. Health Sci. 9(1 ser X), pp. 42–50. https://doi.org/10.9790/1959-0901104250
Firoozabadi, M.D., Ebadi, A., Sheikhi, M.A., Rahmani, H., 2016. Postoperative Pain after Coronary Artery Bypass Grafting Surgery : effect of Relaxation. Presented at the 4th Iranian Cardiovascular Joint Congress, Iranian Heart Association, Tehran, Iran.
Hany, S.M., Ali, Z.H., Mostafa, H.A., 2019. Effect of deep breathing technique on severity of pain among postoperative coronary artery bypass graft patients. Int. J. Nov. Res. Healthc. Nurs. 6(2), pp 32–45.
Hasanvand, A., Ebrahimi, Y., Mohamadi, A., Nazari, A., 2019. Zingiber officinale Roscoe reduces chest pain on patients undergoing coronary angioplasty: A clinical trial. J. Herbmed Pharmacol. 8(1), pp. 47–50. https://doi.org/10.15171/jhp.2019.08
Ibitoye, B.M., Oyewale, T.M., Olubiyi, K.S., Onasoga, O.A., 2019. The use of distraction as a pain management technique among nurses in a North-central city in Nigeria. Int. J. Afr. Nurs. Sci. 11, 100158. https://doi.org/10.1016/j.ijans.2019.100158
Jose, J.A., 2020. Effectiveness of quick relaxation technique on pain associated with chest tube removal among postoperative coronary artery bypass grafting patients in a Tertiary Care Hospital, Delhi. Indian J. Contin. Nurs. Educ. 21(2), pp. 166-170. https://doi.org/10.4103/IJCN.IJCN_134_20
Keawnantawat, P., Thanasilp, S., Preechawong, S., 2018. Effectiveness of cold therapy in reducing acute pain among persons with cardiac surgery: A randomized control trial. Songklanakarin J Sci Technol. 40(6), pp. 1378–1385.
Kessel, K.A., Lettner, S., Kessel, C., Bier, H., Biedermann, T., Friess, H., Herrschbach, P., Gschwend, J.E., Meyer, B., Peschel, C., Schmid, R., Schwaiger, M., Wolff, K.-D., Combs, S.E., 2016. Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients’ Attitude towards CAM in a University-Based Oncology Center in Germany. PLOS ONE. 11(11), pp. e0165801. https://doi.org/10.1371/journal.pone.0165801
Kubota, S., Endo, Y., Kubota, M., Shigemasa, T., 2017. Assessment of effects of differences in trunk posture during Fowler’s position on hemodynamics and cardiovascular regulation in older and younger subjects. Clin. Interv. Aging. 12, pp. 603–610. https://doi.org/10.2147/CIA.S132399
Kyavar, M., Karkhaneh, S., Rohanifar, R., Azarfarin, R., Sadeghpour, A., Alizadehasl, A., Ghadrdoost, B., 2016. Effect of preferred music listening on pain reduction in mechanically ventilated patients after coronary artery bypass graft surgery. Res. Cardiovasc. Med. 5(4), pp 1-6. https://doi.org/10.5812/cardiovascmed.33769
Lantz, R.C., Chen, G.J., Sarihan, M., Sólyom, A.M., Jolad, S.D., Timmermann, B.N., 2007. The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine 14(2-3), pp. 123–128. https://doi.org/10.1016/j.phymed.2006.03.003
Lin, C., Hwang, S., Jiang, P., Hsiung, N., 2020. Effect of Music Therapy on Pain After Orthopedic Surgery—A Systematic Review and Meta‐Analysis. Pain Pract. 20(4), pp. 422–436. https://doi.org/10.1111/papr.12864
Lokesh, B., Jimson, S., Muthumani, T., Parthiban, J., Anandh, B., 2015. Cryotherapy – Following Intraoral Surgeries and for Treatment of Oral Lesions : A Review. Biomed. Pharmacol. J. 8(October Spl Edition), pp. 621–624.
Lown, E.A., Banerjee, A., Vittinghoff, E., Dvorak, C.C., Hartogensis, W., Melton, A., Mangurian, C., Hu, H., Shear, D., Adcock, R., Morgan, M., Golden, C., Hecht, F.M., 2019. Acupressure to Reduce Treatment-Related Symptoms for Children With Cancer and Recipients of Hematopoietic Stem Cell Transplant: Protocol for a Randomized Controlled Trial. Glob. Adv. Health Med. 8, 2164956119870444. https://doi.org/10.1177/2164956119870444
Micah, S., Barolia, R., Parpio, Y., Kumar, S., Sharif, H., 2019. Factors Associated with Postoperative Pain among Patients after Cardiac Surgery in the Tertiary Care Teaching Hospital of Karachi, Pakistan. Pain Res. Treat. 2019, e9657109. https://doi.org/10.1155/2019/9657109
Micozzi, M.S., 2014. Fundamentals of Complementary and Alternative Medicine, 5th ed. Saunders Elsevier, Missouri.
Mohammadi, N., Pooria, A., Yarahmadi, S., Tarrahi, M.J., Najafizadeh, H., Abbasi, P., Moradi, B., 2018. Effects of Cold Application on Chest Tube Removal Pain in Heart Surgery Patients. Tanaffos. 17(1), pp. 29–36.
Mooventhan, A., Khode, V., 2014. Effect of Bhramari pranayama and OM chanting on pulmonary function in healthy individuals: A prospective randomized control trial. Int. J. Yoga. 7(2), pp. 104–110. https://doi.org/10.4103/0973-6131.133875
Narimani, M., Ansari Jaberi, A., Negahban Bonabi, T., Sadeghi, T., 2018. Effect of Acupressure on Pain Severity in Patients Undergoing Coronary Artery Graft: A Randomized Controlled Trial. Anesthesiol. Pain Med. 8(5). https://doi.org/10.5812/aapm.82920
Pal, A.K., Tiwari, S., Verma, D.K., 2017. Effect of recumbent body positions on dynamic lung function parameters in healthy young subjects. J. Clin. Diagn. Res. JCDR. 11(5), pp. CC08-CC10. https://doi.org/10.7860/JCDR/2017/25202.9828
Panggabean, N.S.H., Asiah, N., 2019. Pengaruh akupresur terhadap dismenore pada remaja di SMP Swasta Islam Terpadu Siti Hajar Medan (Skripsi). Universitas Sumatera Utara, Medan.
Pishkarmofrad, Z., Navidian, A., Ahmadabadi, C.A., Aliahmadi, E., 2016. Effects of localized cryotherapy on the severity of thoracic pain in patients undergoing coronary artery bypass grafting. Med.-Surg. Nurs. J. 5(1), pp. 22–27.
Rini, R.A.P., 2018. The effectiveness of deep breathing relaxation technique and guided imagery to decrease pain intensity on postoperative fracture patients in bougenvile ward of Dr Soegiri Hospital Lamongan, in: “Nurses at The Forefront in Transforming Care, Science, and Research.” Presented at the The 9th International Nursing Conference 2018, Universitas Airlangga, Surabaya, pp. 115–121.
Rofi’ah, I.A., Nurachmah, E., Adam, M., 2020. Applied Cold Therapy Before Deep Breathing and Coughing Exercise on Acute Pain Inpatient Who Undergoing Cardiac Surgery. JournalNX. 6(6), pp. 489–499.
Roshita, R.C., 2018. Pengaruh musik slow (instrumental) terhadap penurunan tekanan darah pada kejadian hipertensi remaja dalam rentang usia 15-17 tahun di SMK Plus Nahdlatul ’Ulama Sidoarjo (Karya Ilmiah Akhir). Politeknik Kesehatan Kementerian Kesehatan Surabaya, Surabaya.
Rosy, V., 2016. A study to evaluate the effectiveness of foot massage on the level of pain among postoperative cardio thoracic surgery patients in Vinayaka Mission Hospital at Salem (Master Thesis). The Tamilnadu Dr MGR Medical University, Erode.
Shaybak, E., Abdollahimohammad, A., Rahnama, M., Masinaeinezhad, N., Azadi-Ahmadabadi, C., Firouzkohi, M., 2017. Effects of Reiki energy therapy on saphenous vein incision pain: A randomized clinical trial study. Pharm. Lett. 9(1), pp. 100–109.
Sheykhasadi, H., Abbaszadeh, A., Bonakdar, H., Salmani, F., Tavan, A., Sedri, N., 2019. The Effect of Distraction with a Loved One’s Voice on Pain Reduction While Extracting the Chest Tube after Open Heart Surgery. Open Pain J. 12(1). https://doi.org/10.2174/1876386301912010006
Subadi, I., Laswati, H., 2014. Ekspresi β-endorfin pada penurunan nyeri inflamasi pasca terapi bekam kering. Vokasindo J. Ilmu-Ilmu Terap. Dan Has. Karya Nyata 2(2), pp. 79–85.
Taherian, T., Shorofi, S.A., Zeydi, A.E., Charati, J.Y., Pouresmail, Z., Jafari, H., 2020. The effects of Hegu point ice massage on post-sternotomy pain in patients undergoing coronary artery bypass grafting: A single–blind, randomized, clinical trial. Adv. Integr. Med. 7(2), 73–78. https://doi.org/10.1016/j.aimed.2019.08.001
vanderVaart, S., Berger, H., Tam, C., Goh, Y.I., Gijsen, V.M.G.J., Wildt, S.N. de, Taddio, A., Koren, G., 2011. The effect of distant reiki on pain in women after elective Caesarean section: a double-blinded randomised controlled trial. BMJ Open. 1(1), e000021. https://doi.org/10.1136/bmjopen-2010-000021
Wahyuningsih, I.S., Pandin, M.G.R., 2021. Complementary and alternative therapy for pain and anxiety in cardiovascular disease: A literature review. Preprints. https://doi.org/10.20944/preprints202104.0114.v1
World Health Organization, 2017. Cardiovascular diseases [WWW Document]. Cardiovasc. Dis. - WHO World Health Organ. URL https://www.who.int/westernpacific/health-topics/cardiovascular-diseases (accessed 4.9.21).
Yan, L.-J., Zhang, F.-R., Ma, C.-S., Zheng, Y., Chen, J.-T., Li, W., 2019. Arteriovenous Graft for Hemodialysis: Effect of Cryotherapy on Postoperative Pain and Edema. Pain Manag. Nurs. 20(2), pp. 170–173. https://doi.org/10.1016/j.pmn.2018.07.002
Yarahmadi, S., Mohammadi, N., Ardalan, A., Najafizadeh, H., Gholami, M., 2018. The combined effects of cold therapy and music therapy on pain following chest tube removal among patients with cardiac bypass surgery. Complement. Ther. Clin. Pract. 31, pp. 71–75. https://doi.org/10.1016/j.ctcp.2018.01.006
Zubrzycki, M., Liebold, A., Skrabal, C., Reinelt, H., Ziegler, M., Perdas, E., Zubrzycka, M., 2018. Assessment and pathophysiology of pain in cardiac surgery. J. Pain Res. 11, pp. 1599–1611. https://doi.org/10.2147/JPR.S162067
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