Methods: A systematic review and meta-analysis were conducted (PROSPERO, 2021: CRD42020179867). We searched studies in PubMed, Ovid-LWW, Scopus, Taylor & Francis, Science Direct, EBSCO, Google Scholar, Medline Complete, Cochrane Library and ULAKBIM databases and grey literature for this study. We included the articles published from January 2009 to December 2019. We limited the language to Turkish and English and the design to randomized-controlled trials. All studies were reviewed by two independent researchers. Meta-analysis was performed using the Comprehensive Meta-Analysis version 3.3 software. Heterogeneity was investigated by meta-regression.

Results: A total of 2,462 records were identified, of which 16 studies were included in a random model meta-analysis. The cold application was used in combination with a pharmacological agent in six studies and alone in 13 studies. All patients were older than 16 years and they had at least one chest tube. Cold application was found to be effective in relieving pain during chest tube removal (d=-1.265).

Conclusion: The use of a non-pharmacological method such as cold application is helpful to reduce pain or reduce painkiller doses during chest tube removal. Its use is recommended, as it is effective, easy to use, and cost-effective without any side effects.