The effect of hegu point massage with ice on pain intensity of patient post coronary artery bypass graft surgery

INTERVENTION: control group: Pain intensity is measured by VAS. glass ball with 2×2 sides is put in left hand hegu point without pressure and massage. Time is same intervention group. Intervention 1: Intervention group1: Patient is located in semisitting or sitting position if possible and is asked for him, deep inspiration and then expiration compeletely. In experiment group massage is conducted with ice in sides 2×2 that is wrapped in single layer gauze and placed in plastic glove, in left hand Hegu point with moderate pressure in total time 10 minute (2 minute massage and 15 second break). Pressure intensity is continued until nail whitening appear. Intervention 2: control group: Pain intensity is measured by VAS. glass ball with 2×2 sides is put in left hand hegu point without pressure and massage. Time is same intervention group. Intervention group1: Patient is located in semisitting or sitting position if possible and is asked for him, deep inspiration and then expiration compeletely. In experiment group massage is conducted with ice in sides 2×2 that is wrapped in single layer gauze and placed in plastic glove, in left hand Hegu point with moderate pressure in total time 10 minute (2 minute massage and 15 second break). Pressure intensity is continued until nail whitening appear. CONDITION: pain. ; Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified PRIMARY OUTCOME: Pain. Timepoint: before intervention, immediately after intervention, 30 minute, 60 minute, 120 minute after intervention. Method of measurement: visual analogue scale. SECONDARY OUTCOME: Allergy to cryotherapy. Timepoint: 3 days after intervention. Method of measurement: observation and question from patient. INCLUSION CRITERIA: INCLUSION CRITERIA: age lower than 75 years; not to have history of open heart surgery; ef=35%; ability to speaking and report pain. Exclusion criteria: sensivity to cold; peripheral vascular diseases; Raynaud’s phenomenon diseases; fracture or injury in left hand; Connective tissue diseases; Diabetic neuropathy; lack of consciousness; Intubation continued more than 24 hours; pulmonary artery pressure>50; the need for intra‐ aortic pump; bleeding greater than 200cc from chest tube; repaire or exchange vale surgery with coronary artery bypass graft; severe visual and hearing impairments; addiction to alcohol and narcotics; Body mass Index greater than 30.