Effects of Connective Tissue Massage on Pain After Thoracotomy
Condition: Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Pain can be quite severe after thoracic surgery and effective pain control is highly
      effective in preventing secretion accumulation, atelectasis, infection and hypoxemia. The
      objective was evaluate the effect of a connective tissue massage on pain, applied analgesic
      amounts and length of hospitalization of the patients.The study was conducted at a thoracic
      surgery department of university hospital in Turkey. Fifty-four patients with operated by the
      posterolateral thoracotomy method participated.The patients were randomly allocated to 1 of 2
      groups: a control group (n27) and the experimental group (n27). Standard medical treatment,
      care and pulmonary rehabilitation program were applied to both groups. In addition, a total
      of 5 sessions of connective tissue massage were applied to the experimental group. Pain level
      of the patients was evaluated at every 24 hours as of the zeroth postoperative day. VAS was
      used as a one-dimensional scale for pain assessment. Totally applied analgesic amounts and
      length of hospitalization of the patients were recorded.
    

Detailed description: 
      The patients were randomly divided into two groups as the control group and the experimental
      group by using the Microsoft Excel program (Microsoft Inc., Redmond, WA, USA). The population
      of the study consisted of the patients who were hospitalized at Thoracic Surgery Clinic and
      operated by the posterolateral thoracotomy method. The first group of the study consisted of
      the patients in the control group and the second group consisted of the connective tissue
      massage group. Lobectomy, pneumonectomy, segmentectomy or wedge resection surgeries were
      performed together with posterolateral thoracotomy in both patient groups.

      Standard medical treatment, care and pulmonary rehabilitation program were applied to both
      groups. The patients were mobilized as early as possible. Starting on the postoperative
      zeroth day, a postoperative rehabilitation program including pulmonary rehabilitation and
      early mobilization was applied to every patient in the control and experimental groups by a
      therapist for 1 week as in routine.

      In addition, a total of 5 sessions of connective tissue massage were applied to the
      experimental group as 1 session a day on the postoperative 1st day, 2nd day, 3rd day, 4th
      day, 5th day. Connective tissue massage was only performed to the patients in the
      experimental group. The procedure was performed while the patient was in the sitting position
      on a chair. In order to provide relaxation in the connective tissue, the patient was asked to
      perform a slight anterior tilt and to hold his back upright. The middle fingers were used
      bilaterally in order to provide traction between the cutaneous tissues. In order to prevent
      contraindication, the procedure was applied to the tissues that were 2 inch away from the
      surgical site. Throughout the procedure, oxygen saturation of the patient, if required, the
      heart rate and blood pressure were followed up. The connective tissue massage was started
      from the lumbosacral region (baseline) and was applied to the lower thoracic, scapular,
      inter-scapular and cervico-occipital region according to the vascular response of the
      connective tissue. A total of 5 sessions of connective tissue massage were applied to the
      experimental group as 1 session a day on the postoperative 1st day, 2nd day, 3rd day, 4th
      day, 5th day. Depending on the area of procedure, each session varied between 15 minutes and
      20 minutes. On postoperative 0th day, 1st day, 2nd day, 3rd day, 4th day, 5th day, 6th day
      and 7th day (before the massage in the experimental group) (between 8.00 and 9.00 in the
      morning); in other words, pain level of the patients (n=54) was evaluated at every 24 hours
      as of the zeroth postoperative day.

      Totally applied analgesic amounts of the patients were recorded on the postoperative 0th day,
      1st day, 2nd day, 3rd day, 4th day, 5th day, 6th day, and 7th day. In addition, length of
      hospitalization of the patients was recorded.In the present study, it was found that the
      patients with prolonged hospitalization period had higher postoperative pain and the duration
      of hospitalization was longer in the control group. It was thought that this difference was
      caused by the effects of connective tissue massage on pain.
    

Intervention name(s): Massage
Intervention type(s): Other
Intervention description(s): The connective tissue massage was started from the lumbosacral region (baseline) and was applied to the lower thoracic, scapular, inter-scapular and cervico-occipital region according to the vascular response of the connective tissue.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other
Keywords: Connective tissue massage; Thoracotomy; Pain