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American Journal of Critical Care. 2004;13: 116-125
Copyright © 2004 by the American Association of Critical-Care Nurses.
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Pain Levels Experienced With Activities After Cardiac Surgery

By Lesley B. Milgrom, RN, MSN, Jo Ann Brooks, RN, DNS, Rong Qi, MS, Karen Bunnell, MSN, NP-C, Susie Wuestefeld, RN, MBA and Daniel Beckman, MD. From the School of Nursing (LBM) and School of Medicine (JAB, RQ, KB), Indiana University; Methodist Medical Research Institute (SW); CorVasc MD’s, PC, and Clarian Health, Methodist Hospital (DB), Indianapolis, Ind.

• 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.

• Objectives 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.






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Copyright © 2004 by the American Association of Critical-Care Nurses.