title: Pain levels experienced with activities after cardiac surgery.
abstract: BACKGROUND
  Acute pain is common after cardiac surgery and can keep patients from participating in activities that prevent postoperative complications. Accurate assessment and understanding of pain are vital for providing satisfactory pain control and optimizing recovery.
  
  
  OBJECTIVE
  To describe pain levels for 5 activities expected of patients after cardiac surgery on postoperative days 1 to 6 and changes in pain levels after chest tube removal and extubation.
  
  
  METHODS
  Adults who underwent cardiac surgery were asked to rate the pain associated with various types of activities on postoperative days 1 to 6. Pain levels were compared by postoperative day, activity, and type of cardiac surgery. Pain scores before and after chest tube removal and extubation also were analyzed.
  
  
  RESULTS
  Pain scores were higher on earlier postoperative days. The order of overall pain scores among activities (P < .01) from highest to lowest was coughing, moving or turning in bed, getting up, deep breathing or using the incentive spirometer, and resting. Changes in pain reported with coughing (P = .03) and deep breathing or using the incentive spirometer (P = .005) differed significantly over time between surgery groups. After chest tubes were discontinued, patients had lower pain levels at rest (P = .01), with coughing (P = .05), and when getting up (P = .03).
  
  
  CONCLUSIONS
  Pain relief is an important outcome of care. A comprehensive, individualized assessment of pain that incorporates activity levels is necessary to promote satisfactory management of pain.
authors.affiliation: School of Nursing, Indiana University, Indianapolis, Ind, USA.
authors.forename: Lesley B
authors.initials: LB
authors.lastname: Milgrom
authors.forename: Jo Ann
authors.initials: JA
authors.lastname: Brooks
authors.forename: Rong
authors.initials: R
authors.lastname: Qi
authors.forename: Karen
authors.initials: K
authors.lastname: Bunnell
authors.forename: Susie
authors.initials: S
authors.lastname: Wuestfeld
authors.forename: Daniel
authors.initials: D
authors.lastname: Beckman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures; D015505:Chest Tubes / Q000009:adverse effects; D003371:Cough / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D012119:Respiration; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012146:Rest / Q000502:physiology; D012494:Sampling Studies; D013147:Spirometry / Q000009:adverse effects; D013997:Time Factors