Chest Tube Removal: Pain Management

Paper Summary:

This paper provides a literature overview of chest tube removal with regard to pain management. It further discusses the appropriate nursing interventions that are most applicable to chest tube removal in the light of the research data and studies that are available. It concludes, based on the literature, that there is a need to explore new avenues in addition to the present standard protocols. It also examines how these new techniques, and means of reducing pain in chest tube removal, revolve around a more inclusive and interactive approach to pain management, where aspects such as anxiety and information flow are catered to.

Outline:
Introduction
Literary Overview of the Problematics of Pain Management
Conclusion
Appendix

From the Paper:

"Standard pain management techniques for chest tube removal relate to medications such as Morphine. " Morphine is one of the most often, if not routinely, used opioids for treating pain due to chest tube removal." (Puntillo and Ley, 2004) However, this is not always the most effective procedure in this situation. "...when morphine was used in small doses (ie, a mean [less than or equal to] 3 mg), pain associated with chest tube removal was rated as moderate to severe. Higher morphine doses have not been tested for their effect on such pain. " (Puntillo and Ley, 2004) Other medications include the use of Ketorolac, which is a nonsteroidal anti-inflammatory drug and is considered to be an effective analgesic for pain due to chest tube removal. "

Sample of Sources Used:

• Hartfield MT, Cason CL, Cason GJ. Effects of information about a threatening procedure on patients' expectations and emotional distress. Nurs Res. 1982;31:202-206.
• Milgrom B., Lesley B., Bunnell K., Wuestefeld S. and Beckman D. ( 2004) Pain levels experienced with activities after cardiac surgery. American Journal of Critical Care, March, 2004. Retrieved February 25, 2006, from http://www.findarticles.com/p/articles/mi_m0NUB/is_2_13/ai_114487374
• Nelson A. et al 2005. Measures of the Quality of Pain management by Nurses. Retrieved February 25, 2006, from http://www.inqri.org/uploads/NelsonRevisedPainPaper1105.pdf
• Puntillo K. ( 1994) Dimensions of procedural pain and its analgesic management in critically ill surgical patients. Am J Crit Care 1994:3:116-122.
• Puntillo K. (2003) Pain assessment and management in the critically ill: wizardry or science? American Journal of Critical Care. Retrieved February 25, 2006, from http://www.findarticles.com/p/articles/mi_m0NUB/is_4_12/ai_105556271

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