ماساژ درمانی و کنترل درد بعد از سزارین

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

2 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

3 PhD گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

چکیده

مقدمه: عمل سزارین از اعمال جراحی رایج زنان است و درد و اضطراب بعد از آن از مسائل مهمی است که زنان جوان مشتاق مراقبت از نوزادشان، با آن روبرو می‌باشند. مدیریت درد پس از عمل از ناراحتی بیمار کاسته، باعث راه رفتن سریع‌تر، کاهش مدت بستری در بیمارستان و افزایش رضایت بیمار می‌شود، لذا مطالعه حاضر با هدف بررسی تأثیر ماساژ بر درد پس از سزارین انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی یک سوکور، از مرداد ماه سال 1393 تا تیر ماه سال 1394 بر روی 156 زن نخست‌زا که جهت سزارین الکتیو به بیمارستان امام علی (ع) آمل مراجعه کرده بودند، انجام شد. نمونه‌ها به صورت تخصیص تصادفی در سه گروه 52 نفره ماساژ دست و پا، ماساژ پا و کنترل قرار گرفتند. سپس 4 ساعت پس از دریافت مسکن، شدت درد و علائم حیاتی بیمار قبل، بلافاصله و 90 دقیقه بعد از ماساژ اندازه‌گیری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و STATA (نسخه 12) انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: نتایج مطالعه حاضر، نشان‌دهنده کاهش معنی‌دار درد بلافاصله و 90 دقیقه بعد از ماساژ در گروه‌های مداخله بود (001/0p<)، اما بین دو گروه مداخله کاهش شدت درد اختلاف آماری معنی‌داری وجود نداشت (98/0=p). همچنین روند تغییرات مربوط به برخی متغیر‌های فیزیولوژیک (فشار‌خون و تنفس) بعد از ماساژ معنی‌دار بود (001/0p<)، اما این تغییر برای ضربان نبض معنی‌دار نبود. همچنین به‌دنبال ماساژ کاهش سطح اضطراب (001/0p<) نیز مشاهده شد.
نتیجه‌گیری: ماساژ دست و پا می‌تواند به عنوان یک مداخله مؤثر و بدون عارضه پرستاری در مراقبت و کنترل درد پس از عمل جراحی بیماران کمک‌کننده باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Massage-therapy and post cesarean pain control

نویسندگان [English]

  • Rozita Rezaei 1
  • Susan Saatsaz 2
  • Abbas Alipour 3
  • Zahra Beheshti 1
1 Instructor, Department of Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
3 PhD, Department of Social Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
چکیده [English]

Introduction: Cesarean section is a common surgical surgery in women, and post-cesarean pain and stress are the problems which are faced by young women keen to care of their newborns. Post-operative pain management reduces patient's discomfort, enables quicker walking, reduces hospital stay, and increases patient's satisfaction. This study was performed with aim to determine the effect of massage on post-cesarean pain.
Methods: This single-blind clinical trial was conducted on 156 primiparous women referred to Amol Emam Ali hospital for elective cesarean section from 2014 to 2015. The samples were randomly divided into three groups including hands and foot massage, foot massage, and control groups (n=52 in each group). The, four hours after receiving analgesics, patients' pain intensity and vital signs were measured before, immediately after, and 90 minutes after the massage. Data were analyzed using SPSS software (version 22) and STATA software (version 12). P<0.05 was considered significant.
Results: A significant reduction was observed in pain intensity immediately and 90 minutes after massage in intervention groups (P<0.001), but the difference between two intervention groups was not statistically significant (P=0.98). Moreover, changes in physiological parameters (blood pressure and respiration) were also significant after massage (P<0.001). However, changes in pulse rate were not significant. Also, a significant reduction in level of anxiety was observed after massage (P<0.001).
Conclusion: Massage of hands and feet as an effective intervention with no nursing side-effect can be helpful in care and control of postoperative pain in patients.

کلیدواژه‌ها [English]

  • Cesarean
  • Massage
  • Pain

مراجع

  1. CORONIS Collaborative Group, Abalos E, Addo V, Brocklehurst P, El Sheikh M, Farrell B, et al. Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial. Lancet 2013; 382(9888):234-48.
  2. Bahadori F, Hakimi S, Heidarzade M. The trend of caesarean delivery in the Islamic Republic of Iran. East Mediterr Health J 2013; 19(Suppl 3):S67-70.
  3. Abbaspoor Z, Akbari M, Najar S. Effect of foot and hand massage in post–cesarean section pain control: a randomized control trial. Pain Manag Nurs 2014; 15(1):132-6.
  4. Trowell J. Possible effects of emergency caesarian section on the mother--child relationship. Early Hum Dev 1982; 7(1):41-51.
  5. Büyükyılmaz F, Aştı T. The effect of relaxation techniques and back massage on pain and anxiety in Turkish total hip or knee arthroplasty patients. Pain Manag Nurs 2013; 14(3):143-54.
  6. Miovech SM, Knapp H, Borucki L, Roncoli M, Arnold L, Brooten D. Major concerns of women after cesarean delivery. J Obstet Gynecol Neonatal Nurs 1994; 23(1):53-9.
  7. Ukpong D, Owolabi A. Postpartum emotional distress: a controlled study of Nigerian women after caesarean childbirth. J Obstet Gynecol 2006; 26(2):127-9.
  8. Ronald D, Miller RD. Miller's anesthesia. Postoperartive care, acute postoperative pain. 7th ed. New Y ork: Willams and Wilkins; 2010.
  9. Carvalho FA, Tenório SB. Comparative study between doses of intrathecal morphine for analgesia after caesarean. Braz J Anesthesiol 2013; 63(6):492-9.
  10. Sammour RN, Ohel G, Cohen M, Gonen R. Oral naproxen versus oral tramadol for analgesia after cesarean delivery. Int J Gynecol Obstet 2011; 113(2):144-7.
  11. Mansour GM, Khoshrang H, Taherzadeh AS. Comparing the effects of local infiltration of lidocaine 2% and marcaine 0.25% on the severity of pain in patients after cesarean section. J Guilan Univ Med Sci 2012; 21(83):86-94. (Persian).
  12. Bamigboye AA, Hofmeyr GJ. Caesarean section wound infiltration with local anaesthetic for postoperative pain relief–any benefit? S Afr Med J 2010; 100(5):313-9.
  13. Najar SH, Akbari M, Abbaspoor. Z, Haghighizadeh M. Intensity after caesarean the effect of hand and foot massage on pain intensity after caesarean. J Ilam Univ Med Sci 2013; 20(4):39-48.
  14. Kong TW, Park H, Cheong JY, Min SK, Ryu HS. Efficacy of continuous wound infiltration of local anesthetic for pain relief after gynecologic laparoscopy. Int J Gynecol Obstet 2014; 124(3):212-5.
  15. Mazhari F, Hossein Rezaee H, Mohammad Alizadeh S. The survey of TENS on pain management after cesarean section. Iran J Obstet Gynecol Infertil 2009; 1:47-54. (Persian).
  16. Grealish L, Lomasney A, Whiteman B. Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nurs 2000; 23(3):237-43.
  17. Khoshtarash M, Ghanbari A, Yegane MR, Kazemnejhad E, Rezasoltani P. Effects of foot reflexology on pain and physiological parameters after cesarean section. Koomesh 2012; 14(1):109-16. (Persian).
  18. Rostaminezhad a, Khosravi A, Karimi Z, Mohammad HS, Ghafariyan H, Shaykhi F, et al. Transcutaneous electrical nerve stimulation (tens) on post cesarean section pain. Armaghan Danesh 2003; 7(28):1-8. (Persian).
  19. Titler MG, Rakel BA. Nonpharmacologic treatment of pain. Crit Care Nurs Clin North Am 2001; 13(2):221-32.
  20. Chanif C, Petpichetchian W, Chongchareon W. Does foot massage relieve acute postoperative pain? A literature review. Nurse Med J Nurs 2013; 3(1):483-97.
  21. Wang HL, Keck JF. Foot and hand massage as an intervention for postoperative pain. Pain Manag Nurs 2004; 5(2):59-65.
  22. Kimber L, McNabb M, Mc Court C, Haines A, Brocklehurst P. Massage or music for pain relief in labour: a pilot randomised placebo controlled trial. Eur J Pain 2008; 12(8):961-9.
  23. Henderson JM. Peripheral nerve stimulation for chronic pain. Curr Pain Headache Rep 2008; 12(1):28-31.
  24. Rabiee L, Seyfi S, Shahrbanoo Latifi O. The effect of foot and hand massage on post-cesarean section pain. Anesthesiol Pain 2012; 2(7):102. (Persian).
  25. Hattan J, King L, Griffiths P. The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. J Adv Nurs 2002; 37(2):199-207.
  26. Albert NM, Gillinov AM, Lytle BW, Feng J, Cwynar R, Blackstone EH. A randomized trial of massage therapy after heart surgery. Heart Lung 2009; 38(6):480-90.
  27. Braun LA, Stanguts C, Casanelia L, Spitzer O, Paul E, Vardaxis NJ, et al. Massage therapy for cardiac surgery patients--a randomized trial. J Thorac Cardiovasc Surg 2012; 144(6):1453-9.
  28. Peng S, Ying B, Chen Y, Sun X. Effects of massage on the anxiety of patients receiving percutaneous coronary intervention. Psychiatr Danub 2015; 27(1):44-9.
  29. Degirmen N, Ozerdogan N, Sayiner D, Kosgeroglu N, Ayranci U. Effectiveness of foot and hand massage in postcesarean pain control in a group of Turkish pregnant women. Appl Nurs Res 2010; 23(3):153-8.
  30. Livingston P, Hirst S, Pitcher M, Mann GB, Collins J, Hayman J. Quality of care for women presenting with benign breast conditions. Intern Med J 2005; 35(6):357-8.
  31. Atashi V, Mohammadi F, Dalvandi A, Abdollahi I, Kazemi R. The slow-stroke back massage (SSBM) and shoulder pain in stroke patients who referred to the rehabilitation centre. J Rehabilit 2012; 13(2):34-40.
  32. Mahram B. The guideline for state and trait anexiety test of Spielberger and the instruction for its explanation based on normality test research in Mashahad. [Masters Thesis]. Tehran, Iran: Allameh Tabatabaiee University; 1993.
  33. Bauer BA, Cutshall SM, Engen D, Sundt TM. Comment on “a randomized trial of massage therapy after heart surgery”. Heart Lung 2010; 39(4):345.
  34. Cherkin DC, Sherman KJ, Kahn J, Erro JH, Deyo RA, Haneuse SJ, et al. Effectiveness of focused structural massage and relaxation massage for chronic low back pain: protocol for a randomized controlled trial. Trials 2009; 10:96.
  35. Cherkin DC, Sherman KJ, Kahn J, Wellman R, Cook AJ, Johnson E, et al. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Ann Intern Med 2011; 155(1):1-9.
  36. Hulme J, Waterman H, Hillier V. The effect of foot massage on patients' perception of care following laparoscopic sterilization as day case patients. J Adv Nurs 1999; 30(2):460-8.
  37. Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull 2004; 130(1):3-18.
  38. Koyama T, McHaffie JG, Laurienti PJ, Coghill RC. The subjective experience of pain: where expectations become reality. Proc Natl Acad Sci U S A 2005; 102(36):12950-5.
  39. Ucuzal M, Kanan N. Foot massage: effectiveness on postoperative pain in breast surgery patients. Pain Manag Nurs 2014; 15(2):458-65.
  40. Nazari R, Ahmadzadeh R, Mohammadi S, Rafiei Kiasari J. Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. J Caring Sci 2012; 1(3):129-34.
  41. Abdelaziz SH, Mohammed HE. Effect of foot massage on postoperative pain and vital signs in breast cancer patient. J Nurs Educ Pract 2014; 4(8):115.
  42. Wyatt G, Sikorskii A, Bush TR, Mukherjee R. Team science of nursing, engineering, statistics, and practitioner in the development of a robotic reflexology device. J Soc Integr Oncol 2009; 8(1):14-9.
  43. Mitchinson AR, Kim HM, Rosenberg JM, Geisser M, Kirsh M, Cikrit D, et al. Acute postoperative pain management using massage as an adjuvant therapy: a randomized trial. Arch Surg 2007; 142(12):1158-67.

Nerbass FB, Feltrim MI, Souza SA, Ykeda DS, Lorenzi-Filho G. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery. Clinics 2010; 65(11):1105-10.

مجله زنان، مامایی و نازایی ایران
دوره 20، شماره 4
تیر 1396
صفحه 34-43

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