The Impact of Breath Exercise Training on Postoperative Pain, Anxiety, and Nausea-Vomiting in General Surgery Patients

This study was conducted to determine the effect of breath exercise on post-operative anxiety level, pain, and nausea-vomiting after general surgery. This was a randomized, controlled experimental study. The sample comprised 149 patients who underwent laparoscopic cholecystectomy and hernia (control:73; experimental:76). One day before the operation, the participants in the experimental group were given breathing exercise training, and they were applied 5 times a day for 10 repetitions until the 30th day after the operation.

Today, surgical treatment is one of the areas where technological methods are frequently applied in the treatment of diseases and the recovery process of patients. Problems such as pain, nausea, vomiting, fear and anxiety occur after surgery, and these situations negatively affect the patient's comfort, quality of life, recovery and satisfaction; they also cause the length of hospital stay and the time allocated to nursing care to be extended and the cost to increase. Pain is a frequently seen symptom in the postoperative period. Approximately 86% of patients experience pain to varying degrees during this period. Prolonged postoperative pain paves the way for the development of various physiopathological responses such as immobility, increased oxygen consumption, atelectasis, deep vein thrombosis, tachycardia, hypertension, decreased stomach and intestinal motility, increased blood sugar, urinary retention and delayed wound healing. Anxiety plays an important role in the increase and decrease of pain after surgical intervention. Studies have determined that pain in the preoperative period increases the level of anxiety and that this situation lowers the pain threshold. Effectively managed and controlled postoperative pain; It reduces anxiety levels and facilitates keeping life parameters at an optimal level after surgical intervention.

Postoperative nausea and vomiting are seen in 20-30% of patients after general anesthesia and are the second most common complaint after pain, and this rate increases to 80% in high-risk groups. Despite antiemetic and analgesic drugs, postoperative nausea, vomiting and pain continue to be an important problem for patients today. Although postoperative nausea and vomiting is not a life-threatening complication, it is a condition that makes recovery from anesthesia difficult, causes fluid-electrolyte imbalance, increases the risk of aspiration, causes stress in patients, causes tension in the suture line and prolongs the discharge period. Many different pharmacological approaches have been developed to minimize postoperative nausea, vomiting and pain. However, the side effects of traditional antiemetics and analgesics and the high cost of drugs have increased the interest in the use of non-pharmacological methods.

Breathing exercises can be used as an effective, simple and cost-effective non-pharmacological approach to prevent or reduce the occurrence of postoperative complications. In addition, it has been shown in the literature that it also increases physical function and quality of life. However, patients have difficulty taking deep breaths due to movement restriction and pain in the postoperative period. Therefore, deep breathing exercises need to be performed regularly to support the incision site in order to ensure effective inspiration and expiration in these patients.

Oxygenation of the traumatized tissues must be sufficient for wound healing in the postoperative incisional area. This oxygen requirement is met by effective ventilation. However, after surgery, patients have difficulty in breathing deeply due to reasons such as pain and limitation of movement. Studies have shown that the practice of planned breathing exercises reduces stress in patients in the pre- and post-operative period, provides calming, and positively affects the level of pain and wound healing. In this respect, planned patient education and care to be given to patients before surgery is very effective in preventing complications related to surgical intervention.

One of the basic duties of surgical nurses is to teach and apply deep breathing and coughing exercises to the patient in pre-operative patient education. It is very important to explain the importance of these exercises to the patient and the effects of performing them at regular intervals on the quality of recovery.

However, studies have drawn attention to the fact that the rates of teaching and applying deep breathing exercises to patients are not at the desired level.

In the literature, many non-pharmacological applications such as acupressure, massage, breathing exercises, listening to music, chewing gum have been performed on patients after surgery and their effects on parameters such as pain, nausea-vomiting, anxiety, vital signs, early discharge, and early mobilization have been examined. There are studies on the relationship between breathing exercises and pain, anxiety, and nausea-vomiting after general surgery surgery, but they are limited. Therefore, the aim of this study is to determine the effect of breathing exercises on pain, anxiety, and nausea-vomiting in patients hospitalized in the general surgery clinic.

Eligibility Criteria:
Inclusion Criteria:

* 18 years and over, Having undergone general surgery with general anaesthesia. They do not have physical/mental disabilities, limitations and diseases that would prevent them from breathing exercises (such as the use of drugs that affect breathing and requiring oxygen therapy, etc.) Cognitive level scales are suitable for application; patients with video phones and no communication problems were included in the study.

Exclusion Criteria:

* Postoperative hemodynamic values unstable, Developing any complications such as severe bleeding, nausea, vomiting after surgery, Leaving work voluntarily, Patients with acute or chronic lung disease were not included in the study.