The Effect of Performance Massage on Pain and Bleeding in Patients Undergoing Open Thyroidectomy: A Randomized Clinical Trial

Abstract

Background: Pain and bleeding are common complications among patients undergoing open thyroidectomy. Research suggests that complementary treatments, such as massage therapy, may help reduce postoperative complications. Therefore, this randomized controlled clinical trial aimed to evaluate the effect of massage on pain and bleeding in patients undergoing open thyroidectomy. Objectives: The present study was conducted with the aim of determining the effect of massage on pain and bleeding in patients undergoing open thyroidectomy in the operating room of a selected hospital affiliated with Isfahan University of Medical Sciences during the year 2023 - 2024. Methods: This randomized controlled clinical trial was conducted on 44 patients referred to Al-Zahra Hospital of Isfahan, Iran, between October 2024 and April 2025, all of whom underwent open thyroidectomy. The participants were randomly assigned to either the control or experimental group (22 patients each). In the experimental group, massage therapy was performed by the researcher. In this group, three massage therapy sessions were performed: In the recovery room, on the first postoperative day, and on the third postoperative day. The duration of each massage therapy session was 15 to 20 minutes. Pain was assessed using the Visual Analog Scale (VAS). Bleeding was evaluated based on the volume of drainage and the amount of blood in the hemovac drain in both groups. Hemoglobin and hematocrit levels were recorded from the patient's medical records prior to surgery and again at 24 and 48 hours postoperatively. Data were analyzed using SPSS version 23. Statistical tests, including repeated measures analysis, independent t-test, and chi-square test, were used to compare the results between the groups. Results: The findings indicated that changes in the mean pain score varied over time, with a significant reduction in pain observed in the experimental group (P < 0.001). Prior to the intervention, the mean pain score was 8.75 ± 0.23 in the experimental group and 8.80 ± 0.23 in the control group, with no statistically significant difference between them (P = 0.88). However, at the assessed time points following the intervention, the difference became significant (P < 0.001). Additionally, there was no statistically significant difference in the volume of blood collected in the drain at 24 (P = 0.79) and 48 hours (P = 0.93) post-surgery between the intervention and control groups, suggesting that the intervention had no effect on postoperative bleeding. Conclusions: The present study demonstrated that massage therapy significantly reduced pain in patients undergoing thyroidectomy. However, it did not affect the volume of bleeding, including drain secretions, hemoglobin levels, or hematocrit. Given the limited sample size, further research on a larger population is recommended.