Abstract
BACKGROUND: Chest tube placement is essential for draining air or fluid from the pleural cavity, often performed after cardiothoracic surgeries to prevent complications. However, chest tube removal (CTR) can be painful and stressful for patients. Proper pain management is crucial to enhancing patient comfort. AIM: The aim of this systematic review and meta-analysis was to asssess the effectiveness of breathing and relaxation exercises for pain associated with CTR. METHODS: Database searches were carried out in Pub med, Web of Science, MEDLINE, Academic Search Ultimate, CINAHL Complete, Cochrane Library, Science Direct to December 2024. The Risk of Bias 2 tool was used to assess the risk of bias. Heterogeneity and publication bias were also assessed. FINDINGS: A total of 8 randomized controlled trials were included. Findings indicated that breathing relaxation exercises had a negative effect on chest tube removal. The mean effect size for the effect of breathing relaxation exercises on CTR was - 1.46 Three of the studies included in the meta-analysis assessed outcomes before CTR procedure. The mean effect size is 0.070 with a 95% confidence interval of -0.208 to 0.348. Also, four of the studies included in the meta-analysis assessed outcomes immediately after the procedure. The mean effect size is -1.403 with a 95% confidence interval of -2.337 to -0.469. The mean effect size in the universe of comparable studies could fall anywhere in this interval. Q-value is 30.826 with 3 degrees of freedom and p < 0.001. CONCLUSIONS: The results of this meta-analysis indicated that breathing and relaxation exercises can be effective in reducing pain associated with the CTR procedure.