Reducing Blood Pressure and SRAS Scores in Preoperative CDL Patients Through Alternate Nostril Breathing Exercise (ANBE)
DOI:
https://doi.org/10.26699/jnk..v13i2.ART.p160-172Keywords:
Alternate Nostril Breathing Exercise (ANBE), Blood Pressure, Preoperative CDL, SRAS ScoreAbstract
Patients diagnosed with CKD often experience changes in both physiological and psychological responses. Alternate Nostril Breathing Exercise (ANBE) has been reported to influence cardiorespiratory and autonomic functions, as well as to reduce anxiety and stress scores. The objective of the study was to analyze the effectiveness of ANBE on the stability of physiological and psychological responses in preoperative patients undergoing CDL insertion at Ratu Zalecha Hospital, Martapura. The study employed a quasi-experimental design with a Pretest-Posttest Control Group Design. The total sample size was 30. The instruments used included an observation sheet and the Zung Self-Rating Anxiety Scale questionnaire. The tool required to measure blood pressure is the Omron HEM-7120 digital sphygmomanometer. The data were analyzed univariately with frequency distribution and bivariately with paired t-test and independent t-test. Data were analyzed using univariate and bivariate methods. The result revealed a significant difference in systolic blood pressure between the control group and the intervention group, with a mean ± SD of 179.6±28.45 in the intervention group and 154 ±15.96 in the control group. Similarly, there was a significant difference in diastolic blood pressure between the two groups, with a mean ± SD of 102.47 ± 10.41 in the intervention group and 91.40 ± 7.82 in the control group. In conclusion, ANBE has the potential to serve as a method for managing preoperative stress and physiological responses (such as blood pressure).It is recommended that nurses in inpatient or pre-operative rooms are encouraged to provide brief training and assistance in performing Alternate Nostril Breathing Exercise to pre-operative patients.
References
Acheampong, R. (2023). Hospitalization characteristics and predictors of renal failure of inpatients in the united states. In ProQuest Dissertations & Theses Global: The Humanities and Social Sciences Collection.
Ashwini, D., & Anandraj, V. (2020). Effect of Left and Right Nostril Breathing on Heart Rate Variability among Healthy Adult Males: A Cross-sectional Study. International Journal of Physiology, 8(02), 34–38. https://doi.org/10.37506/ijop.v8i2.1239
Chandrababu, R., Kurup, S. B., Ravishankar, N., & Ramesh, J. (2019). Effect of pranayama on anxiety and pain among patients undergoing cardiac surgery: A non-randomized controlled trial. Clinical Epidemiology and Global Health, 7(4), 606–610. https://doi.org/10.1016/j.cegh.2019.01.009
Chen, I. C., Yang, S. C., Liu, K. T., & Wu, Y. H. (2019). Delayed malposition of a double-lumen hemodialysis catheter that caused hemorrhage and hypovolemic shock. Medicine (United States), 98(3), 2018–2020. https://doi.org/10.1097/MD.0000000000014192
Cimen, S. G., Oğuz, E., Gundogmus, A. G., Cimen, S., Sandikci, F., & Ayli, M. D. (2020). Listening to music during arteriovenous fistula surgery alleviates anxiety: A randomized single-blind clinical trial. World Journal of Transplantation, 10(4), 79–89. https://doi.org/10.5500/wjt.v10.i4.79
Cramer, H., Haller, H., Lauche, R., Steckhan, N., Michalsen, A., & Dobos, G. (2014). A systematic review and meta-analysis of yoga for hypertension. American Journal of Hypertension, 27(9), 1146–1151. https://doi.org/10.1093/ajh/hpu078
El-ghafar, H. S. A., Taha, A. S., & Samah Elsayed Ghonaem, N. F. M. (2025). Effect of Alternate Nostril Breathing Exercise on Preoperative Patients’ Anxiety, Blood Pressure and Heart Beats. Journal of Nursing Science- Benha Univercity, 6(1), 391–407.
Gall, M., Gall, J., & Borg, R. (2007). Educational research: An introduction (8th ed.). Pearson Education.
Garg, P., Mendiratta, A., Banga, A., Bucharles, A., Victoria, P., Kamaraj, B., Qasba, R. K., Bansal, V., Thimmapuram, J., Pargament, R., & Kashyap, R. (2024). Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis. International Journal of Cardiology: Cardiovascular Risk and Prevention, 20(July 2023), 200232. https://doi.org/10.1016/j.ijcrp.2023.200232
Geiger, C., Cramer, H., Anheyer, D., Dobos, G., & Kohl-Heckl, W. K. (2025). A systematic review and meta-analysis of yoga for arterial hypertension. PLoS ONE, 20(5 May), 1–22. https://doi.org/10.1371/journal.pone.0323268
Hagins, M., States, R., Selfe, T., & Innes, K. (2013). Effectiveness of yoga for hypertension: Systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2013. https://doi.org/10.1155/2013/649836
Hanan Mohamed Mohamed, S. (2020). Efficacy of Alternate Nostril Breathing for Controlling Blood pressure, Anxiety and Heart rate among Egyptian Hypertensive Patients - An interventional one arm Study. Egyptian Journal of Health Care, 11(2), 622–634. https://doi.org/10.21608/ejhc.2020.166533
Hasaini, A. M. M. (2024). EFFECTIVENESS OF CYCLIC SIGHING ON RESPIRATORY RATE AND FUNCTION IN PATIENTS WITH PNEUMONIA Asni. Indonesian Journal of Global Health Research, 6(5), 3083–3092. https://doi.org/10.37287/ijghr.v2i4.250
Hecking, M., Hödlmoser, S., Ahmed, S. B., & Carrero, J. J. (2022). The Other Way Around: Living With Chronic Kidney Disease From the Perspective of Men. Seminars in Nephrology, 42(2), 122–128. https://doi.org/10.1016/j.semnephrol.2022.04.003
Hustrini, N. M., Susalit, E., & Rotmans2, J. (2022). Prevalence and risk factors for chronic kidney disease in Indonesia: An analysis of the National Basic Health Survey 2018. Journal of Global Health, 12, 1–10. https://doi.org/10.7189/jogh.12.04071
Jagadeesan, T., R, A., R, K., Jain, T., Allu, A. R., Selvi G, T., Maveeran, M., & Kuppusamy, M. (2022). Effect of Bhramari Pranayama intervention on stress, anxiety, depression and sleep quality among COVID 19 patients in home isolation. Journal of Ayurveda and Integrative Medicine, 13(3), 100596. https://doi.org/10.1016/j.jaim.2022.100596
Jahan, I., Begum, M., Akhter, S., Islam, M. Z., Jahan, N., Samad, N., Das, P., Rahman, N. A. A. A., & Haque, M. (2021). Effects of alternate nostril breathing exercise on cardiorespiratory functions in healthy young adults. Annals of African Medicine, 20(2), 69–77. https://doi.org/10.4103/aam.aam_114_20
Kalaivani, MJ, K., & GK, P. (2019). Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry. Journal of Education and Health Promotion, 8(July), 1–8. https://doi.org/10.4103/jehp.jehp
Kamath, A., Urval, R. P., & Shenoy, A. K. (2017). Effect of alternate nostril breathing exercise on experimentally induced anxiety in healthy volunteers using the simulated public speaking model: A randomized controlled pilot study. BioMed Research International, 2017. https://doi.org/10.1155/2017/2450670
Khalid, A., Srivastava, S., & Sciences, B. (2024). Effect of Alternate Nostril Breathing on Blood Pressure among Hypertensives in a Selected Urban Community of Gurugram (Haryana). The Nursing Journal of India, CXV(5), 212–216. https://doi.org/10.48029/NJI.2024.CXV504
Kumar, N., & Pradhan, B. (2017). Immediate role of two yoga-based breathing technique on state anxiety in patients suffering from anxiety disorder: A self as control pilot study. International Journal of Yoga - Philosophy, Psychology and Parapsychology, 5(1), 18. https://doi.org/10.4103/ijny.ijoyppp_9_16
Kustriyani, M., & Endang Supriyanti. (2024). Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal. TERAPI RELIGI DZIKIR PADA KECEMASAN PASIEN GAGAL GINJAL KRONIS, 15(1), 75–82. https://journal2.stikeskendal.ac.id/index.php/PSKM/article/view/1979/1260
Lai, Y. J., Chen, Y. Y., Lin, Y. K., Chen, C. C., Yen, Y. F., & Deng, C. Y. (2019). Alcohol consumption and risk of chronic kidney disease: A nationwide observational cohort study. Nutrients, 11(9), 1–9. https://doi.org/10.3390/nu11092121
Levey, A. S., Titan, S. M., Powe, N. R., Coresh, J., & Inker, L. A. (2020). Kidney disease, race, and gfr estimation. Clinical Journal of the American Society of Nephrology, 15(8), 1203–1212. https://doi.org/10.2215/CJN.12791019
Levin, C. J., & Swoap, S. J. (2019). The impact of deep breathing and alternate nostril breathing on heart rate variability: A human physiology laboratory. Advances in Physiology Education, 43(3), 270–276. https://doi.org/10.1152/ADVAN.00019.2019
Mohamed Soliman, H. (2020). Efficacy of Alternate Nostril Breathing for Controlling Blood Pressure, Anxiety and Heart rate among Egyptian Hypertensive Patients – An Interventional Study. Egyptian Journal of Health Care, 11(2), 622–634. https://doi.org/10.21608/ejhc.2020.166533
Murdeshwar, H., & F, A. (2023). Hemodialysis. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK563296/
Nam, T. G., Jeong, H., Kim, K. H., & Jang, I. (2024). Effectiveness of Alternative Nostril Breathing on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Complement Med Res, 31(5), 449–460. https://doi.org/10.1159/000539707
Okolie, J. (2024). Prevalence of Chronic Kidney Disease and Awareness Levels Among Young Adults in Imo and Anambra States, Nigeria. Walden University.
Raut, V., & Deshmukh, P. D. (2020). Effect of Alternate Nostril Breathing Exercise on pre exam anxiety in Healthy Physiotherapy students. International Journal of Allied Medical Sciences and Clinical Research (IJAMSCR), 8(3), 672–680.
Roshni, V. (2024). Effect of Alternate Nostril Breathing Exercise on Cardiorespiratory Functions in Hypertensive Adults: A Systematic Review. International Journal for Multidisciplinary Research (IJFMR), 6(6), 1–9.
Saunders, M. R., Ricardo, A. C., Chen, J., Anderson, A. H., Cedillo-Couvert, E. A., Fischer, M. J., Hernandez-Rivera, J., Hicken, M. T., Hsu, J. Y., Zhang, X., Hynes, D., Jaar, B., Kusek, J. W., Rao, P., Feldman, H. I., Go, A. S., Lash, J. P., & Steubl, D. (2020). Neighborhood socioeconomic status and risk of hospitalization in patients with chronic kidney disease: A chronic renal insufficiency cohort study. Medicine (United States), 99(28), E21028. https://doi.org/10.1097/MD.0000000000021028
Sigdel, D. S. (2015). Perioperative anxiety: A short review. Global Anesthesia and Perioperative Medicine, 1(4), 107–108. https://doi.org/10.15761/gapm.1000126
Sofyan, S., Azzam, R., & Mustikasari, M. (2020). Effect of Breathing Nostril and Back Massage On Blood Pressure Reduction in Hypertension Patients in The Working Area of Hospital Pertamina Jaya. STRADA Jurnal Ilmiah Kesehatan, 9(2), 1396–1402. https://doi.org/10.30994/sjik.v9i2.484
Suryawanshi, M., Dutta, P., Ganduboina, R., Rajput, V., & Pawar, S. G. (2023). Standardization of Pre-operative Evaluation to Improve the Outcome of Arteriovenous Fistula for Vascular Access of Hemodialysis: A Review of 700 Cases. Cureus, 15(9). https://doi.org/10.7759/cureus.45999
Telles, S., Sharma, S. K. uma., & Balkrishna, A. (2014). Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical Science Monitor Basic Research, 20, 184–193. https://doi.org/10.12659/MSMBR.892063
Trotman, G. P., Veldhuijzen van Zanten, J. J. C. S., Davies, J., Möller, C., Ginty, A. T., & Williams, S. E. (2019). Associations between heart rate, perceived heart rate, and anxiety during acute psychological stress. Anxiety, Stress and Coping, 32(6), 711–727. https://doi.org/10.1080/10615806.2019.1648794
Upadhyay Dhungel, K., Malhotra, V., Sarkar, D., & Prajapati, R. (2008). Effect of alternate nostril breathing exercise on cardiorespiratory functions. Nepal Medical College Journal : NMCJ, 10(1), 25–27. https://doi.org/10.36948/ijfmr.2024.v06i06.301622
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic Kidney Disease. The Lancet, 389(10075), 1238–1252. https://doi.org/10.1016/S0140-6736(16)32064-5
Yu, Z., Rebholz, C. M., Wong, E., Chen, Y., Matsushita, K., Coresh, J., & Grams, M. E. (2019). Association Between Hypertension and Kidney Function Decline: The Atherosclerosis Risk in Communities (ARIC) Study. American Journal of Kidney Diseases, 74(3), 310–319. https://doi.org/10.1053/j.ajkd.2019.02.015
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
