The Active Cycle of Breathing Technique significantly reduced pain and anxiety and increased arterial oxygen saturation compared to standard care in patients recovering from CABG surgery.
RCT (n=76)
Single-blind
Permuted block randomization (block size of 4)
No
Does the Active Cycle of Breathing Technique improve pain, anxiety, and arterial oxygen saturation in patients recovering from CABG surgery?
The Active Cycle of Breathing Technique may be a useful adjunct to standard respiratory care for reducing pain and anxiety and improving oxygenation in post-CABG patients.
p-value: p=<0.001
Purpose Addressing pain and anxiety after coronary artery bypass grafting (CABG) is essential. This research evaluates the associations between the Active Cycle of Breathing Technique (ACBT) and pain levels, anxiety, and blood oxygen saturation in patients recovering from CABG surgery. Method Seventy-six patients undergoing CABG surgery were randomly assigned using permuted block randomization (19 blocks of 4 participants) to either the intervention group (n = 38) or the control group (n = 38). After exclusions (2 reoperations in control, 1 withdrawal in intervention), 73 patients completed the study (intervention: n = 37; control: n = 36). The intervention group received ACBT alongside standard respiratory care, consisting of four sessions (two sessions daily at 10:00 AM and 5:00 PM on postoperative days 2 and 3), with each session lasting 10 min and including three phases: breathing control, thoracic expansion exercises, and coughing technique. The control group received standard respiratory care with incentive spirometry (10–20 deep breaths per session) over the same schedule. Outcome measures pain (Visual Analog Scale), anxiety (State-Trait Anxiety Inventory), and arterial oxygen saturation (pulse oximetry) were assessed before intervention and after each of the four sessions by a blinded research assistant. Data were analyzed using repeated measures ANOVA. Results Baseline pain levels differed significantly between groups (p = 0.005), with the intervention group reporting higher pain. After adjusting for baseline differences, the ACBT group demonstrated significantly lower pain scores after the second (p < 0.001), third (p = 0.007), and fourth (p < 0.001) sessions compared to the control group. Anxiety levels were significantly lower in the ACBT group after all four sessions (p = 0.005, p = 0.019, p = 0.010, p = 0.004, respectively). Arterial oxygen saturation was significantly higher in the ACBT group after all four sessions (p < 0.001). Repeated measures ANOVA revealed significant group effects for pain (p < 0.001), anxiety (p = 0.006), and oxygen saturation (p < 0.001). Time effects were significant for anxiety (p < 0.001) and oxygen saturation (p < 0.001), but not for pain (p = 0.491). The group × time interaction was significant only for oxygen saturation (p < 0.001). Conclusion ACBT was associated with lower pain and anxiety and higher arterial oxygen saturation in patients after CABG surgery. These findings suggest that ACBT may warrant consideration for integration into postoperative respiratory care protocols, pending further research with stronger methodological controls. However, the absence of participant blinding and potential attention bias limit causal inference, and future studies with sham controls are needed.
Kooshkqazi et al. (Wed,) conducted a rct in Coronary artery bypass grafting (CABG) (n=76). Active Cycle of Breathing Technique (ACBT) vs. Standard respiratory care with incentive spirometry was evaluated on Pain intensity (Visual Analog Scale) group effect across sessions (p=<0.001). The Active Cycle of Breathing Technique significantly reduced pain and anxiety and increased arterial oxygen saturation compared to standard care in patients recovering from CABG surgery.