Menthol Massage for Post-Bypass Pain & Anxiety

Coronary artery bypass graft surgery (CABG) is a frequently preferred surgical treatment method for coronary artery disease (CAD). After surgery, patients experience complications such as pain and anxiety associated with sternotomy. Reducing pain and anxiety levels in the postoperative period may be effective in speeding up the discharge process for patients. Back pain after sternotomy is a significant source of concern for patients who have undergone heart surgery. Galao-Malo states that pain often radiates from the sternum to the sides of the chest and eventually to the back, where it may become more musculoskeletal in nature. Additionally, the surgical approach itself, the patient's position during surgery, and the resulting tension in the back and shoulders can contribute to musculoskeletal pain. Studies have shown that inadequate pain control in the postoperative period can exacerbate these problems and lead to chronic pain syndromes. Both pharmacological and non-pharmacological methods are used in postoperative pain management. Massage is effective in reducing patients' pain levels as a non-pharmacological method. A study by Sözen determined that foot massage has a positive effect on reducing postoperative pain levels. In addition, massage increases blood flow and reduces pain levels by promoting the release of endorphins. For this reason, massage therapy is recommended for managing pain symptoms after CABG. This study aims to investigate the effect of post-operative back massage with mentholated ointment and paraffin oil on pain and anxiety levels in patients who have undergone coronary artery bypass graft surgery. It is anticipated that the data obtained will contribute to evidence-based practices and promote the wider use of non-pharmacological methods for pain and anxiety management by nurses.

Inclusion criteria

• Willing to participate in the study,
• Who has undergone bypass surgery,
• Aged 18 years or older,
• No visual impairment (except those who can see better with visual aids), hearing impairment (except those who can hear better with hearing aids), or speech impairment/communication problems that would prevent them from understanding the information provided and accurately describing their pain,
• Literate,
• Possesses orientation to person, place, and time,
• Has a sternum exposure time of at least 2 hours during surgery,
• Does not use any complementary alternative medicine methods,
• Meets ASA 1 and ASA 2 criteria,
• Elective (planned) surgery patients will be included.

Exclusion criteria

• Individuals with allergies to menthol ointment and paraffin oil used during the procedure,
• Individuals participating in a different study conducted at the clinic,
• Individuals experiencing confusion,
• Individuals with physical and cognitive problems that prevent massage from being applied,
• Individuals diagnosed with mood disorders (depression, panic attacks, dysthymia, bipolar disorder, or taking any medication for these conditions),
• Individuals with respiratory problems,
• Individuals who cannot speak Turkish, and cannot read or write Turkish
• Transferred to intensive care during the postoperative period,
• Experiencing severe bleeding, hematoma, seroma, or nerve injury during the postoperative period,
• Developing an allergy to mentholated ointment/paraffin oil used during massage,
• Voluntarily requesting to leave the job,
• Individuals who do not comply with the work process and conditions will be removed from the study.