This study is being conducted to determine the effect of EMLA cream and cold application on pain, fear and vital signs before chest tube removal in children aged 7-18 years.
A chest tube is a device used to drain air or fluid from the pleural cavity under sterile conditions by inserting a thin or thick tube. Chest tubes adhere to the endothelium of the chest cavity after insertion and while in place. For this reason, the pulling force applied when they are removed breaks these adhesions and causes intense, localised and transient acute pain. Chest tube removal pain, defined as one of the patient's worst life experiences related to the surgical procedure, is an iatrogenic pain caused by an invasive procedure. Therefore, chest tube removal is a painful, anxious and frightening experience for the patient. There are few studies of pharmacological and non-pharmacological methods of pain control during chest tube removal in children. However, the management of pain associated with surgical procedures in childhood is very important for the management of pain, anxiety and fear that children will experience with future medical procedures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
66
EMLA cream is applied once, 3 hours before the tube is removed. EMLA cream will be applied by the researcher in a thin layer to an area of 7-10 cm2, with the chest tube entrance to the skin remaining in the center. It will be covered with a Tegaderm transparent film dressing.
Cold application will be made with an ice cube pack immediately before the chest tube removal procedure. Cold application will be applied to a 7 cm diameter area, with the chest tube entrance to the skin being considered as the center. Skin temperature will be measured with an infrared thermometer and will be ensured to reach 13.0 degrees. Ice pack application is expected to last approximately 9-10 minutes.
Istanbul Medeniyet University
Istanbul, Turkey (Türkiye)
Procedural pain score- Wong-Baker FACES Pain Rating Scale
The scale is used to diagnose pain in children aged 3-18 years. It consists of six facial expressions, each one representing an increasing degree of pain scored on a scale 0 to 5 from left to right. The first face is a happy face representing "no pain=0" while the last face is a crying face representing "the worst pain imaginable=5". Higher scores indicate low pain tolerance. Participants are asked to choose the facial expression that best represents their pain.
Time frame: 3 hours before the procedure, immediately before the procedure, 1 minute after the procedure and 5 minutes after the procedure
Procedural fear score- Children's Fear Scale (CFS)
The CFS was developed to measure fear and anxiety in children. It consists of five facial expressions that represent a range from neutral to extreme fear. It is scored between 0 and 4. Both researchers and family members can use the CFS to measure fear and anxiety in children before and during procedure.
Time frame: 3 hours before the procedure, immediately before the procedure, 1 minute after the procedure and 5 minutes after the procedure
Oxygen saturation
Children will be connected to a pulse oximeter monitor; oxygen saturation will be monitored before, during and after the procedure.
Time frame: 3 hours before the procedure, immediately before the procedure, 1 minute after the procedure and 5 minutes after the procedure
Pulse rate
Children will be connected to a pulse oximeter monitor; their pulse rate will be monitored before, during and after the procedure.
Time frame: 3 hours before the procedure, immediately before the procedure, 1 minute after the procedure and 5 minutes after the procedure
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