Introduction: After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization.
Methods: In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain’s check list was applied to evaluate the severity of bleeding and hematoma.
Results: None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference.
Conclusion: Based on the findings of this study, changing patients’ position can be safe and they can be ambulated early after angiography.
Cardiac catheterization is widely used for diagnostic evaluations in patients with cardiac diseases.1 Annually, approximately 3 million cardiac catheterizations are performed in the United States.2 For performing cardiac catheterization, the access to heart is established through a catheter which in more than 95% of cases perform through the percutaneous femoral artery using Seldinger technique.3 Like any other invasive procedures, the access to heart through femoral artery have complications, such as: arrhythmias, vascular access complications (including bleeding and hematoma), myocardial ischemia, coronary artery rupture, hemodynamic collapse, cerebrovascular accident including TIA Transient Ischemic Attacks), contrast material allergy and acute renal failure.4 The most common complications after coronary angiography are vascular complications.5
According to the presented protocol, it is safe and feasible to change the patients’ position and to permit early ambulation after coronary angiography. In addition, body change position prevents a backache and reduces its intensity and consequently increases a physical comfort. It also eliminates the possible negative attitudes of patients towards coronary angiography.
Moreover, this positioning method avoid wasting nurses’ time on explaining the reason of patients’ complete bed-rest, prescribing analgesics as well as massaging the patient’s back in order to relieve the pain.
Limitations of study: Since bleeding and hematoma were observed in any groups, more samples were needed.