The Effectiveness of Acupressure for Managing Postoperative Pain and Anxiety in Patients With Thoracoscopic Surgery

Study Overview
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Brief Summary
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The purpose of this study is to explore the effectiveness of acupressure for managing postoperative pain, anxiety, analgesia consumption, early ambulation, and comfort in patients with thoracoscopic surgery.

Detailed Description
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Thoracoscopic surgery is the surgical used to removal of a section or a segment of a lung lobe. One US national survey reported that 80% of patients undergoing pulmonary surgery experienced acute pain. 75-86% of these patients pointed out that experienced moderate, severe, or extreme pain, especially, on the 1st day after thoracoscopic surgery. However, inappropriate pain management after surgery is associated with limited the healing process, increased workload of heart, prolonged pulmonary rehabilitation, and increased medical costs, and can be a prediction of developing chronic pain. Acupressure is a nonpharmacological treatment for the management of postoperative pain. Recent studies have found that the application of acupressure is effective in decreasing operative pain intensity, morphine related side effects, and opioid consumptions after surgery. However, there was no further research about the role of acupressure applied to thoracoscopic surgery.

Official Title
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Professor, School of Nursing, China Medical University Hospital, Principal Investigator

Conditions
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Lung Diseases

Intervention / Treatment
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* Other: acupressure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pulmonary lung disease and will be scheduled to undergo a thoracoscopic wedge resection, segmentectomy, or lobectomy. American Society of Anesthesiologist physical status of Classes I-II, both forearms without missing limbs or arteriovenous fistula ability to communicate in Taiwanese or Chinese, and agreement to participate in this study. Exclusion Criteria: diagnosed as malignant neoplasm with lung meta, Had a stroke or peripheral vascular disease Platelet count less than 20 x 10^3/mm^3 Using the patient controlled analgesia, and any known mental illness or memory dysfunction.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: acupressure<br>After recruitment, participants will be randomized to receive acupressure or control group. In the acupressure group, participants will receive acupressure treatment. | Other: acupressure<br>* The acupressure involves the  Vaccaria Semen within skin-colored adhesive tape that placed on the Neiguan and Shenmen acupoints as an intervention measure. Continue to massage the acupoints with fingertips for 10 minutes, 3 times per day (8 and 12 in the morning, and 4 in the afternoon) . The adhesive tape will be retained in situ for 2 days.<br>|
| No Intervention: routine care<br>After recruitment, participants will be randomized to receive acupressure or control group. In the control group, participants will receive routine care, including routine pain control. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain:Changes from baseline pain scale at post-operative day 2, after intervention. | as assessed by Visual Analogue Scale-Pain (VAS-P). The VAS-P scale is comprised of a horizontal line 100mm long with the indication no pain to the left and worst possible pain to the right. possible scores varied between 0-100. A higher scores mean a worse outcome. | Measure at before operation day, 7 post meridiem (PM), before operation; post-operative day1, 8 ante meridiem (AM), before intervention; post-operative day 1, 5 PM, after intervention; and post-operative day 2, 5 PM, after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anxiety | as assessed by Visual Analogue Scale-Anxiety(VAS-A). The VAS-A scale is comprised of a horizontal line 100mm long with the indication no anxiety to the left and worst possible anxiety to the right. possible scores varied between 0-100. A higher scores mean a worse outcome. | Measure at before operation day, 7 post meridiem (PM), before operation; post-operative day1, 9 ante meridiem (AM), before intervention; post-operative day 1, 5 PM, after intervention; and post-operative day 2, 5 PM, after intervention. | 
| Anxiety | as assessed by State-Trait Anxiety Inventory (STAI) Y form (STAI-Y1). It is 20 questions, which were rated from 1-4. Possible scores varied between 20-80. A STAI-Y1 score>40 as evidence of a state of anxiety. | Time Frame: Measure at before operation day, 7 post meridiem (PM), before operation; post-operative day1, 8 ante meridiem (AM), before intervention; and post-operative day 2, post meridiem (PM), after intervention. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acupressure, thoracoscopic surgery, acute pain, anxiety, comfort