Progressive Muscle Relaxation May Reduce Pain and Improve Sleep After Open Heart Surgery
Photo by Gustavo Torres / Unsplash
Key Takeaway
Consider PMR as a potential non-pharmacological adjunct for pain and sleep after cardiac surgery, but recognize evidence is from a small single-center study.
A single-center, single-blind randomized controlled trial evaluated Progressive Muscle Relaxation (PMR) in 60 patients after open heart surgery. The intervention group received twice-daily PMR sessions on postoperative days 1, 2, and 3, while the control group received usual care. Pain was assessed using the Short-form McGill's Pain Questionnaire, and sleep quality was measured with the Richard-Campbell Sleep Questionnaire.
In the PMR group, pain scores decreased from 9.36 points on day 1 to 1.50 points on day 3, a change reported as statistically significant (p < .001). In the control group, pain scores decreased to 6.13 points on day 3. The study reported a significant difference in pain reduction between the two groups. For sleep quality, scores reached 545.83 points on day 3 in the PMR group, compared to 330.16 points in the control group, with a significant difference reported between groups.
Safety and tolerability data were not reported in the abstract. Key limitations include the small sample size (n=60), single-center design, and the lack of reported primary outcome, effect sizes, confidence intervals, and baseline characteristics. The authors recommend nurses consider including PMR in postoperative care protocols. While the RCT design supports causal inference within the study, the limited scope and unreported data mean these findings should be interpreted as preliminary evidence requiring confirmation in larger, more robust trials.
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View Original Abstract ↓
PURPOSE: This study aimed to evaluate the effectiveness of Progressive Muscle Relaxation (PMR) on postoperative pain level and sleep quality in patients undergoing open heart surgery.
DESIGN: A single center, two-group, single-blind randomized controlled trial.
METHODS: This study comprised 60 patients who were admitted to the cardiovascular surgery department and undergoing open heart surgery between January 2023 and April 2024. Patients were randomized into 30 in the experimental group and 30 in the control group. Data were collected using Patient Identification Form, Short-form of McGill's Pain Questionnaire (SF-MPQ) and Richard-Campbell Sleep Questionnaire (RCSQ). PMR were applied twice a day, morning and evening, on the post-operative days 1st, 2nd, and 3rd days to experimental group. Before and after PMR, the patients' pain level and sleep quality were evaluated. The control group received usual care and treatment.
RESULTS: In the experimental group, pain level decreased significantly from 9.36 points on the 1st day to 1.50 points on the 3rd day in the post-operative service (p < .001). In the control group, pain level decreased only to 6.13 points on the 3rd day. It was determined that sleep quality gradually increased in the experimental group and reached 545.83 points on the 3rd day in the post-operative service. In the control group, it increased only to 330.16 points. A significant difference was found pain level and sleep quality in all measurements between the experimental and control groups.
CONCLUSIONS: In this study, it was suggested that progressive muscle relaxation reduces pain and improves sleep quality in patients undergoing open heart surgery. It is recommended that nurses include progressive muscle relaxation in postoperative pain control and sleep management in usual care.
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