Effect of Regular Smooth Breathing on the Intensity of Pain Caused by Dressing Change in Patients with Second-Degree Burns: A Clinical Trial

Abstract

Background: The pain caused by wound dressing is common in burn patients. Using respiratory techniques is one of the nonpharmacological methods of pain control that has remained understudied in burn patients. Objectives: The aim of this study was to probe the effect of regular smooth breathing on the pain induced by dressing change in patients with second-degree burns. Methods: This clinical trial was performed on 30 qualified patients with second-degree burns. The subjects were chosen through random sampling and assigned to experimental (n = 15) and control (n = 15) groups. The respiratory intervention was carried out in four dressing change sessions for the experimental group while the control group received only the routine care. The data were collected using a demographic questionnaire and a visual analog scale (VAS) for measuring pain intensity. The results were subsequently analyzed in SPSS 23 using the chi-square test, Fisher-exact test, and independent t-test. Results: Pain intensity after dressing was significantly lower in experimental group than control group in all four dressing sessions (P < 0.05). Conclusions: Regular smooth breathing reduces the pain caused by dressing burn injuries. Therefore, this intervention is recommended for burn patients.

Effects of Slow Deep Breathing on Acute Clinical Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…In the Westerdahl et al RCT, 33 the breathing intervention was used five times daily during the postoperative course, but the frequency of use was incompletely described in the other two acute postoperative pain RCTs. 30 , 31 The duration of use was limited to the period of acute labor pain and pain during dressing changes in the obstetric 28 , 32 and acute burn 29 , 34 RCTs, respectively. In the three acute postoperative pain RCTs, the duration of use was two days, 31 three days 30 and two months.…”

“…The seven RCTs reported three different pain scales. Five RCTs reported a visual analog scale (VAS) ranging from 0-100, 28 , 30 - 32 , 34 one RCT reported a VAS ranging from 0-10, 29 and one RCT reported a bodily pain subscale of the Short-Form Health Survey (SF-36) ranging from 0-100. 33 In addition to the VAS, a single RCT reported a visual descriptor scale ranging from 1-7 which was anchored with four pain descriptors (eg, no pain, mild, moderate, severe) placed equidistant on a vertical line.…”

“…Heterogeneity was investigated using subgroup analyzes based on pain etiology (burn, obstetric labor and postoperative) and RoB (low, some and high) ( Figure 2 ). Two RCTs 29 , 34 reported pain intensity in patients experiencing burn pain, and pooled subgroup analysis demonstrated SDB was associated with statistically lower pain scores compared to controls (SMD −2.24, 95% CI −3.49 to −0.98) but high levels of heterogeneity were observed ( I 2 = 77%) ( Figure 3 ). Two RCTs 28 , 32 reported pain intensity in patients experiencing obstetric labor pain but pooled subgroup analysis demonstrated no significant group differences in pain scores between the SDB and control groups (SMD −0.19, 95% CI −0.53 to 0.15; I 2 = 62%).…”

“…Seven RCTs (N = 847) met inclusion and exclusion criteria (Table 1). [28][29][30][31][32][33][34] Two studies involved patients with acute burn pain (n = 98), 29,34 two studies involved patients with acute obstetric labor pain (n = 390), 28,32 and three studies involved patients with acute postoperative pain (n = 403). 30,31,33 Four RCTs assessed physical functioning and psychological distress 28,30,33 and one study assessed psychosocial outcomes.…”

The effect of modified relaxation breathing technique on pain anxiety in patients with second-degree burns: A clinical trial study

“…In addition to conventional pharmacological methods, non-pharmacological ones can be used to control pain anxiety; using cognitive-behavioral techniques, for instance, effectively reduce pain anxiety [3]. Breathing techniques are one of the methods of distraction that includes several types such as diaphragmatic breathing, yoga breathing, unilateral nostril breathing, hi-ho rhythmic breathing, and four-count deep regular breathing [4]. Despite significant advances in the management of anxiety, there is still a lack of managing or controlling it in burn patients.…”