Penerapan Pursed-Lip Breathing terhadap Penurunan Nyeri dan Sesak Napas pada Pasien Post Thorakotomy: Laporan Kasus Asuhan Keperawatan

Abstract

 Thoracotomy is a thoracic surgical procedure that often causes acute pain and impaired breathing patterns due to chest wall incision, tissue manipulation, chest drainage placement, and limited lung expansion. These conditions restrict deep breathing, effective coughing, and mobilization, thereby delaying respiratory recovery. Pursed-lip breathing (PLB) is a simple non-pharmacological nursing intervention that may reduce dyspnea and improve patient comfort. This case report aimed to describe the application of PLB in reducing pain and dyspnea in a post-thoracotomy patient. Nursing care was provided for 3 × 24 hours to one post-thoracotomy patient in the Teratai Ward of Prof. Dr. Margono Soekarjo Regional Hospital, Purwokerto. Data were collected through interviews, observation, physical examination, vital sign monitoring, pain assessment, respiratory rate, oxygen saturation, breath sound evaluation, and medical records. Interventions included PLB, pain management, semi-Fowler positioning, oxygenation monitoring, collaborative analgesic administration, and infection prevention. Before the intervention, the patient experienced postoperative chest pain with a pain score of 7/10, dyspnea, a respiratory rate of 22 breaths/minute, shallow breathing, nasal flaring, crackles, and oxygen saturation of 98% while receiving oxygen at 4 L/minute via nasal cannula. On the second day, the pain score decreased to 5/10, dyspnea improved, respiratory rate decreased to 20 breaths/minute, oxygen saturation increased to 99%, and nasal flaring resolved. By the third day, the pain score further decreased to 4/10, dyspnea resolved, respiratory rate remained 20 breaths/minute, and oxygen saturation was 98% without supplemental oxygen. These findings suggest that pursed-lip breathing may serve as an effective complementary nursing intervention to reduce pain and dyspnea in post-thoracotomy patients.