The effect of pranayama and pursed lip breathing exercise on pain and respiration after coronary bypass surgery

Albayram, T. (2024). The Effect of Pranayama and Pursed Lip Breathing Exercise on Pain and Respiration after Coronary Bypass Surgery. Istanbul University- Cerrahpasa Institute of Graduate Studies. Department of Surgical Nursing. PhD Thesis. Istanbul. Aim: To examine the effects of pranayama and pursed lip breathing exercise on pain and breathing after coronary bypass surgery. Method: The research, designed as a randomized controlled, single-blind and experimental, was conducted between May 2022 and March 2023 at Gaziantep University Şahinbey Research and Application Hospital. With the sample determined by power analysis, 66 patients who would undergo CABG surgery and were informed about the research were randomly divided into three equal groups: pranayama (N= 22), pursed-lip breathing (N= 22) and control (N= 22). While no treatment was performed on the patients in the control group, the patients in the intervention groups performed Nadi Shodhana and pursed lip breathing exercises for 15 minutes a day for seven days, respectively. To determine the effectiveness of breathing exercise, the patient's FVC, FEV1, FEV1/FVC levels were measured with a spirometer device. A visual comparison scale was used to determine the pain level of the patients. Respiratory parameters (FVC, FEV1, FEV1/FVC) were recorded on the patient follow-up form. The data obtained were evaluated by number, percentage, mean, t test, Kruskal Wallis H test, Mann-Whitney U test, Wilcoxon test and Pearson correlation analysis with the SPSS Statistics 25.0 (IBM Corp., Armonk, NY, USA) program. Results: The age of the patients was 63.67±8.97 years, 72.7% were male, 80.3% were married, and BMI was 39.4%, which was at a normal level. The descriptive characteristics are similar in pranayama, pursed-lip breathing and control group patients (p>0.05), and in the pranayama group, moderate pain was observed on day 0 and statistically significant on days 1, 2, 3, 4, 5, and 6. and it clinically decreased to a mild pain level on the 6th day, patients in the pranayama group felt less pain than pursed-lip breathing and control group patients, and there was an increase in FVC, FEV1, FEV1/FVC levels; In pranayama group patients, the pain intensity decreased the most on the 6th postoperative day, and the highest increase was observed in postoperative FVC, FEV1, 4th, 5th and 6th day FEV1/FVC levels compared to the preoperative period (p<0.01); It was found that 15-minute pranayama application was the most effective application on FVC, FEV1, FEV1/FVC and pain levels measured on the 6th postoperative day (η2=7.63) (p<0.01). Conclusion: Pranayama application CABG surgery showed that it is clinically more useful in reducing pain in the early postoperative period and in bringing postoperative FVC, FEV1, FEV1/FVC levels to normal limits. Therefore, pranayama can be safely applied within the scope of nursing care interventions in pain and respiratory management in the early postoperative period.