Reflexology Massage and Hot Water Foot Bath for Pain and GI Recovery After Colorectal Surgery

This randomized controlled trial aims to evaluate the effectiveness of two non-pharmacological interventions-reflexology massage and hot water foot bath-on postoperative pain and gastrointestinal function in patients undergoing laparoscopic colorectal cancer surgery. The interventions will be applied in three groups: reflexology massage, hot water foot bath, and control group. Participants will be randomly assigned to groups using a computerized randomization method. Pain will be assessed using the Numerical Rating Scale (NRS), and gastrointestinal function will be evaluated through time to first gas and feces passage, as well as bowel sounds. Additionally, the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) will be used to monitor symptoms related to postoperative nausea and vomiting. Data will also be collected using a researcher-developed Data Collection Form consisting of:

• Sociodemographic characteristics
• Medical and surgical history
• Postoperative vital signs (blood pressure, pulse, temperature, etc.)
• Gastrointestinal follow-up (bowel sounds per minute, time of first gas and feces output) This form was developed based on current literature and clinical practice guidelines and piloted prior to study launch. All data will be analyzed using SPSS 21.0.

The sample size was calculated using G*Power based on an effect size of 0.4 (Cohen), 95% power, and a 0.05 margin of error, resulting in 102 total participants (n=34 per group).

Ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Fenerbahçe University. The study is being conducted at the General Surgery Clinic of SBÜ Ümraniye Training and Research Hospital.

Inclusion criteria

• 18 years of age or older,
• Planning laparoscopic surgery for a malignant tumour in the large intestine,
• The same method was used for preoperative bowel and GI tract preparation,
• Postoperative Numerical Proportioning Scale (NRS) score of 3 and above,
• Verbal and written acceptance to participate in the research.

Exclusion criteria

• The patient has a temporary or permanent stoma,
• Having a history of reflexology application before,
• Open wound, infection, circulatory disorder, lesion, etc. in the areas where reflexology massage or hot water foot bath will be applied,
• Patient-controlled analgesia in the early postoperative period
• Having any problem that prevents verbal communication.