Post-thoracotomy Pain Management With Active External Warming and Ice Application
Condition: Post Operative Pain; Pain, Acute; Thoracic Injury
MeSH terms: Pain, Postoperative; Acute Pain; Thoracic Injuries
Study type: Interventional

Summary: 
      The aim of study is to investigate the effects of active external warming of patient
      concurrently with application of ice to incision site on thoracotomy pain and analgesic
      consumption. The research is a quasi-experimental design with control and study groups.
    

Detailed description: 
      The study was initiated after obtaining the written approval of the study centers. The center
      of the study and the hospital where the research was conducted. Written permission was
      obtained from the hospital management. Within the scope of the research, the research was
      explained to the participants and their consent was obtained.

      The routine analgesia protocol was applied to patients in the control group. In addition to
      the routine analgesia protocol, the study group was administered non-pharmacological pain
      control interventions comprising active external warming and ice application. In the
      Intensive Care Unit (ICU), all patients stayed in the same area without a separator so they
      could easily observe each other's interventions and hear the conversations occurring during
      medical intervention. For this reason, the control group was evaluated first. After the last
      patient in the control group was transferred to the clinic, the study group was evaluated.

      Active External Warming: In the literature, the use of electric blankets and warm blowing
      devices were recommended as the best methods for postoperative active external warming.In
      this study, methods used routinely in the Intensive Care Unit (ICU) such as cotton blankets
      and socks were used for the control group. In addition to the cotton blankets and socks,
      electric blankets were used for the patients in the intervention group. In accordance with
      the literature, the temperature of the electric blanket was set at 38 °C (Celsius) at the
      beginning and increased to a maximum of 40-41 °C based on the patient's body temperature.

      Application of ice to the incision site: Studies have reported that the cooling effect of ice
      packs is higher than that of cooled gel packs. In the intervention group, an ice pack was
      applied to the incision site for pain control in addition to active external warming. Ice
      packs at 0-5 °C with external dimensions of 160 × 91 × 34 mm and a filled weight of 363 g
      that were kept in the fridge were used for ice application. In this study, ice packs were
      applied in the first 12 postoperative hours for 20 minutes every 2 hours, and a parallel pain
      assessment was performed.

      Measurements of body temperature, analgesic consumption, and pain level were made to evaluate
      the effectiveness of active external warming and ice application. The measurements and
      follow-up of the patients in the study and control groups in the ICU were carried out by
      these investigators.
    

Intervention name(s): Active external warming; Ice application
Intervention type(s): Other; Other
Intervention description(s): In this study, methods used routinely in the Intensive Care Unit (ICU) such as cotton blankets and socks were used for the control group. In addition to the cotton blankets and socks, electric blankets were used for the patients in the intervention group. In accordance with the literature, the temperature of the electric blanket was set at 38 °C (Celsius) at the beginning and increased to a maximum of 40-41 °C based on the patient's body temperature .; In the intervention group, an ice pack was applied to the incision site for pain control in addition to active external warming. Ice packs at 0-5 °C with external dimensions of 160 × 91 × 34 mm and a filled weight of 363 g that were kept in the fridge were used for ice application. To prevent direct contact of the ice pack with the patient's skin, the ice pack was wrapped in a thin cotton sheath.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Supportive Care
Keywords: Postthoracotomy pain control; Active external warming; Pain management; Ice application; Nursing care