The Effect of Pranayama on Pain and Respiration After Coronary Bypass Surgery

The Effect of Pranayama and Pursed Lip Breathing Exercise on Pain and Respiration After Coronary Bypass Surgery

After CABG surgery, patients tend to breathe superficially because they experience pain while breathing. By restricting deep inspiration and cough; There is a decrease in lung tidal volume, vital capacity, and functional residual capacity. Accordingly, alveolar ventilation also decreases, and the oxygenation levels of the organs decrease due to alveolar collapse or developing hypoxemia. Due to the pain experienced, patients cannot cough and secretions accumulate in the alveoli. Due to accumulated secretions, patients are more prone to atelectasis and lung infections. The risk of pulmonary embolism increases in patients due to the limitation of movement caused by pain. It is aimed to replace these weak breathing patterns with conscious breathing patterns provided by pranayama. While pranayama improves regular, slow, and deep breathing, it activates nasal breathing and provides diaphragmatic breathing. Thanks to the suction pressure created in the chest cavity with diaphragmatic breathing, the venous return of blood also improves. Along with all these changes, it also helps reduce the heart's workload by regulating circulatory functions such as blood pressure, heart rate, left ventricular pressure, and coronary artery diameter. Alternating nasal breathing, slow and deep breathing, applied during pranayama, helps relieve breathing work in eliminating excessive breathing patterns. In addition, nasal breathing balances sympathetic and parasympathetic activity and makes an important contribution to the regulation of the activities of the autonomic nervous system. The vagus nerve, which has a parasympathetic effect, stimulates the left nostril, diagram, stomach, hypothalamus, pineal gland, and suprachiasmatic nucleus and stimulates the diaphragm and stomach, and with this control of the autonomic nervous system, it helps to keep the respiratory rate within normal ranges, improve breathing, reduce stress hormones and help relaxation. Controlled inspiration, breath holding, and slow expiration practices performed with pranayama also contribute to increasing the general capacity of the lungs and gradually improving respiratory functions.

Inclusion Criteria:

• CABG surgery performed on a stopped heart (On pump),
• Cardiopulmonary risk index score ≤2
• Those aged 18 and over,
• Being literate and communicative,
• American Society of Anesthesiologists (ASA) classification I or II,
• Preoperative respiratory function tests with normal FEV1, FVC, FEV1/FVC values,
• No complications developed during and after the surgical intervention,
• An analgesic drug with the same active ingredient is applied to control pain after surgical intervention,
• Patients who were administered antibiotics with the same active ingredient after surgical intervention were included.

Exclusion Criteria:

• CABG surgery performed on a working heart (off-pump),
• Cardiopulmonary risk index score ≥4
• Complications developing during or after surgery,
• Intubated,
• Those with chronic pain in the pre-surgical period,
• Those with limited movement activity before surgery,
• Having a body mass index (BMI≥30),
• Patients who could not adapt to and tolerate the pranayama technique were not included in the study.