In the United States, it is stated that cardiac surgery can result in various sources of pain. Inevitably, there is pain associated with the wound, and beyond the sternotomy incision, there may be an extensive leg wound from vein harvesting. Other contributors to pain and discomfort include drains in the mediastinal and pleural regions, tracheal tubes, and urethral catheters. Activities such as physiotherapy, movement, and tracheal toileting (suctioning of secretions) can contribute to the patient's distress. Typically, acute pain from the incisions becomes more manageable after the third day, but complications may arise, leading to additional pain. These complications encompass wound infection, hematoma formation, sternal dehiscence, pleural effusion, pneumonia, and myocardial infarction. Bacterial mediastinitis and pericarditis occasionally serve as significant sources of severe pain, and patients who have recently experienced a myocardial infarction may develop Dressler's syndrome. Intraoperative chest wall retraction can result in trauma to the thoracic cage, potentially causing the development of conditions such as costochondritis or musculoskeletal and myofascial pain postoperatively. H1: The pain score following a foot massage is expected to be notably reduced compared to the pain score before receiving the foot massage. H2: A significant correlation is anticipated between the post-foot massage pain score and certain variables like age and type of surgery. Indeed, associations were identified between the pre-foot massage pain score and age (χ2 = 52.7344), previous analgesic use (χ2 = 14.9246), non-pharmacological management (χ2 = 22.5466), and previous surgery (χ2 = 18.7098). Consequently, the research hypothesis was accepted, and the null hypothesis was rejected. Conversely, no significant associations were observed between pre-foot massage pain and demographic variables such as age, education (χ2 = 1.4284, P > 0.05), occupation (χ2 = 3.1677, P > 0.05), sex (χ2 = 0.033879), and type of surgery (χ2 = 5.9). Recommendations:This research can be conducted again with a broader sample size that includes patients undergoing general surgery to enhance its applicability. Additionally, replicating this study with a larger participant pool and incorporating a control group would be beneficial.

Keywords:Cardiac surgery, demographic variables, foot massage pain, musculoskeletal and myofascial pain, sternotomy incision

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Wang HL, Keck JF. Foot and hand massage as an intervention for postoperative pain. Pain Manag. Nurs. Jun 2004; 5(2): 59–65. DOI: 10.1016/j.pmn.2004.01.002.
2. Saatsaz S, Rezaei R, Alipour A, Beheshti Z. Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial. Complement Ther. Clin. Pract. Aug 2016; 24: 92–98. DOI: 10.1016/j.ctcp.2016.05.014.
3. Bruce J et al. The prevalence of chronic chest and leg pain following cardiac surgery: A historical cohort study. Pain. Jul 2003; 104(1–2): 265–273.
4. Ho SC, Royse CF, Royse AG, Penberthy A, McRae R. Persistent pain after cardiac surgery: An audit of high thoracic epidural and primary opioid analgesia therapies. Anesth. Analg. Oct 2002; 95(4): 820–823. DOI: 10.1097/00000539-200210000-00006.
5. Kshettry VR, Carole LF, Henly SJ, Sendelbach S, Kummer B. Complementary alternative medical therapies for heart surgery patients: Feasibility, safety, and impact. Ann Thorac. Surg. Jan 2006; 81(1): 201–205. DOI: 10.1016/j.athoracsur.2005.06.016.
6. Bijur PE, Latimer CT, Gallagher EJ. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad. Emerg Med. Apr 2003; 10(4): 390–392. DOI: 10.1111/j.1553-2712.2003.tb01355.x.
7. Lee JH, Kim HA, Park SW. Prevention of fall in the hospital. J Korean Med Assoc. 2015; 58: 123–130. DOI: 10.5124/jkma.2015.58.2.123.
8. Abdellah F, Levine E. Better Patient Care Through Nursing Research. New York: Macmillan Publishing Company; 1989. pp. 56–68.
9. Black JM, Jacobs EM, Sorensen L. Medical Surgical Nursing: A Psychologic Approach. 6th edition. Philadelphia: W. B. Saunders Company; 1993. pp. 40–62.
10. Billhult C. Trial. Autonomic Neuroscience. Jun 2008; 140(1–2): 88–95.
11. Halme J et al. The effect of foot massage on patients’ perception of care following laparoscopic sterilization as day care patients. J Adv Nurs. Aug 1999; 30(2): 460–468.
12. Akhtar RP, et al. Anticoagulation in patients following prosthetic heart valve replacement. Ann. Thorac. Cardiovasc Surg. 2009; 15(1): 10–17.
13. Ansell J et al. The pharmacology and management of the vitamin K antagonists: The Seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. Sep 2004; 126(3): 204s–233s.
14. Baker JW, Pierce KL. INR goal attainment and oral anticoagulation knowledge of patients enrolled in anticoagulation. J Manag Care Pharm. 2011; 17(2): 133–142.
15. Thachil J. The newer direct oral anticoagulants: A practical guide. Clin Med. Apr 2014; 14(2): 165–175. DOI: 10.7861/clinmedicine.14-2-165.

In the United States, it is stated that cardiac surgery can result in various sources of pain. Inevitably, there is pain associated with the wound, and beyond the sternotomy incision, there may be an extensive leg wound from vein harvesting. Other contributors to pain and discomfort include drains in the mediastinal and pleural regions, tracheal tubes, and urethral catheters. Activities such as physiotherapy, movement, and tracheal toileting (suctioning of secretions) can contribute to the patient's distress. Typically, acute pain from the incisions becomes more manageable after the third day, but complications may arise, leading to additional pain. These complications encompass wound infection, hematoma formation, sternal dehiscence, pleural effusion, pneumonia, and myocardial infarction. Bacterial mediastinitis and pericarditis occasionally serve as significant sources of severe pain, and patients who have recently experienced a myocardial infarction may develop Dressler's syndrome. Intraoperative chest wall retraction can result in trauma to the thoracic cage, potentially causing the development of conditions such as costochondritis or musculoskeletal and myofascial pain postoperatively. H1: The pain score following a foot massage is expected to be notably reduced compared to the pain score before receiving the foot massage. H2: A significant correlation is anticipated between the post-foot massage pain score and certain variables like age and type of surgery. Indeed, associations were identified between the pre-foot massage pain score and age (χ2 = 52.7344), previous analgesic use (χ2 = 14.9246), non-pharmacological management (χ2 = 22.5466), and previous surgery (χ2 = 18.7098). Consequently, the research hypothesis was accepted, and the null hypothesis was rejected. Conversely, no significant associations were observed between pre-foot massage pain and demographic variables such as age, education (χ2 = 1.4284, P > 0.05), occupation (χ2 = 3.1677, P > 0.05), sex (χ2 = 0.033879), and type of surgery (χ2 = 5.9). Recommendations:This research can be conducted again with a broader sample size that includes patients undergoing general surgery to enhance its applicability. Additionally, replicating this study with a larger participant pool and incorporating a control group would be beneficial.

Keywords:Cardiac surgery, demographic variables, foot massage pain, musculoskeletal and myofascial pain, sternotomy incision

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Wang HL, Keck JF. Foot and hand massage as an intervention for postoperative pain. Pain Manag. Nurs. Jun 2004; 5(2): 59–65. DOI: 10.1016/j.pmn.2004.01.002.
2. Saatsaz S, Rezaei R, Alipour A, Beheshti Z. Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial. Complement Ther. Clin. Pract. Aug 2016; 24: 92–98. DOI: 10.1016/j.ctcp.2016.05.014.
3. Bruce J et al. The prevalence of chronic chest and leg pain following cardiac surgery: A historical cohort study. Pain. Jul 2003; 104(1–2): 265–273.
4. Ho SC, Royse CF, Royse AG, Penberthy A, McRae R. Persistent pain after cardiac surgery: An audit of high thoracic epidural and primary opioid analgesia therapies. Anesth. Analg. Oct 2002; 95(4): 820–823. DOI: 10.1097/00000539-200210000-00006.
5. Kshettry VR, Carole LF, Henly SJ, Sendelbach S, Kummer B. Complementary alternative medical therapies for heart surgery patients: Feasibility, safety, and impact. Ann Thorac. Surg. Jan 2006; 81(1): 201–205. DOI: 10.1016/j.athoracsur.2005.06.016.
6. Bijur PE, Latimer CT, Gallagher EJ. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad. Emerg Med. Apr 2003; 10(4): 390–392. DOI: 10.1111/j.1553-2712.2003.tb01355.x.
7. Lee JH, Kim HA, Park SW. Prevention of fall in the hospital. J Korean Med Assoc. 2015; 58: 123–130. DOI: 10.5124/jkma.2015.58.2.123.
8. Abdellah F, Levine E. Better Patient Care Through Nursing Research. New York: Macmillan Publishing Company; 1989. pp. 56–68.
9. Black JM, Jacobs EM, Sorensen L. Medical Surgical Nursing: A Psychologic Approach. 6th edition. Philadelphia: W. B. Saunders Company; 1993. pp. 40–62.
10. Billhult C. Trial. Autonomic Neuroscience. Jun 2008; 140(1–2): 88–95.
11. Halme J et al. The effect of foot massage on patients’ perception of care following laparoscopic sterilization as day care patients. J Adv Nurs. Aug 1999; 30(2): 460–468.
12. Akhtar RP, et al. Anticoagulation in patients following prosthetic heart valve replacement. Ann. Thorac. Cardiovasc Surg. 2009; 15(1): 10–17.
13. Ansell J et al. The pharmacology and management of the vitamin K antagonists: The Seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. Sep 2004; 126(3): 204s–233s.
14. Baker JW, Pierce KL. INR goal attainment and oral anticoagulation knowledge of patients enrolled in anticoagulation. J Manag Care Pharm. 2011; 17(2): 133–142.
15. Thachil J. The newer direct oral anticoagulants: A practical guide. Clin Med. Apr 2014; 14(2): 165–175. DOI: 10.7861/clinmedicine.14-2-165.