title: Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery.
abstract: BACKGROUND
  Coughing and deep breathing after sternotomy causes severe pain. This study was conducted to assess the effect of cold therapy on the pain in patients undergoing open heart surgery.
  
  
  METHODS
  In a randomized controlled trial (RCT) with crossover design, 50 eligible and consenting patients were recruited and randomly allocated to gel pack and non-gel pack groups on the first postoperative day. All patients performed four episodes of deep breathing and coughing (DB and C) every 2 h. Pain intesity was measured and compared at rest and after DB and C in both groups. At the end of the study, all patients were asked about their preferences for the cold gel pack application prior to DB and C. The study hypotheses were analyzed using repeated measures analysis of variance (RM-ANOVA).
  
  
  RESULTS
  Data analysis showed significant reduction in pain scores (P < 0.001) after cold gel application. Forty-five (90%) patients were inclined to reapply the gel pack in the future.
  
  
  CONCLUSIONS
  Cold gel pack can reduce the pain associated with DB and C in cardiac surgery patients.
authors.affiliation: Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: HamidReza
authors.initials: H
authors.lastname: Khalkhali
authors.affiliation: Department of Nursing, Iranshar University of Medical Sciences, Iranshahr, Iran.
authors.forename: Zahra Ebrahimi Rigi
authors.initials: ZE
authors.lastname: Tanha
authors.affiliation: Department of Nursing, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Aram
authors.initials: A
authors.lastname: Feizi
authors.affiliation: Department of Cardiac Surgery, Seyed Al-shohada Cardiovascular Center, Urmia University of Medical Sciences, Urmia, IR, Iran.
authors.forename: Shahyad Salehi
authors.initials: SS
authors.lastname: Ardabili
keywords: Cold gel pack; deep beathing and coughing; open heart surgery; pain