The Effect of Acupressure Application on Respiratory Performance and Pain Levels in Adult Patients Undergoing Cardiac Surgery

Cardiovascular diseases remain a major global health burden. While open-heart surgery is a vital treatment for many cardiac conditions, it is characterized by a high risk of complications and a long recovery period. Postoperative pulmonary complications, including hypoxemia, pneumonia, atelectasis, and respiratory failure, are prevalent among these patients. To prevent these issues and restore lung expansion, the regular use of an incentive spirometer is a standard and essential component of nursing care in the cardiovascular surgical intensive care unit.

However, severe postoperative pain restricts patients' ability to take deep breaths, which significantly reduces the effectiveness of incentive spirometry and increases the risk of lung complications. Furthermore, pharmacological agents commonly used for pain management can cause adverse effects like respiratory depression. This has directed nursing practice toward non-pharmacological, complementary symptom management strategies.

Acupressure is a non-invasive complementary therapy rooted in traditional medicine, involving the application of physical pressure to specific acupoints. Current literature indicates that stimulating specific points, such as LU7 (Lieque) and PC6 (Neiguan), can regulate autonomic nervous system activities, increase parasympathetic tone, and improve overall respiratory function. Although its potential in general symptom management is recognized, clinical evidence regarding the direct impact of acupressure on respiratory performance in post-cardiac surgery intensive care patients remains highly limited. This study aims to address this gap by determining the physiological and clinical effects of acupressure on both pain levels and respiratory capacity in this specific patient population.

Inclusion criteria

• Aged 18 years and older.
• Undergoing cardiac surgery for the first time.
• Extubated and hemodynamically stable in the postoperative period.
• A Glasgow Coma Scale (GCS) score of 15.
• Absence of arterial or venous catheters, incisions, hematomas, ecchymoses, or any skin lesions/deformities at the acupressure application sites.
• No analgesic medication administered within the last four hours.
• No known neuromuscular diseases that could affect respiratory muscle strength or performance.
• Ability to speak Turkish and absence of any communication barriers.

Exclusion criteria

• Development of postoperative complications (e.g., severe arrhythmia, need for re-intubation, active bleeding).
• Receiving sedation in the intensive care unit.
• Presence of chronic pain syndrome or regular use of opioids/analgesics.
• Known psychiatric disorders.