Procedure-Related Access Site Pain Multimodal Management following Percutaneous Cardiac Intervention: A Randomized...

Area of Science:

• Cardiology
• Pain Management
• Post-procedural Care

Background:

• Percutaneous coronary intervention (PCI) can lead to post-procedural pain, affecting patient recovery.
• Effective pain management strategies are crucial for improving outcomes after PCI.

Purpose of the Study:

• To evaluate the efficacy of a multimodal pain management (MPM) approach in reducing arm-shoulder (A-S) pain after PCI.
• To compare A-S pain prevalence and intensity between an intervention group receiving MPM and a control group receiving standard pain medication.

Main Methods:

• 137 patients undergoing radial artery PCI were randomized into an intervention group (IG) receiving MPM (paracetamol, ibuprofen, physiotherapy) and a control group (CG).
• Outcomes, including A-S pain prevalence and intensity (Numeric Rating Scale), were assessed at multiple time points up to 3 months post-PCI.

Main Results:

• The IG showed significantly lower A-S pain prevalence at 24h (18.5% vs 41.2%), 48h (1.5% vs 30.9%), 1 week (10.8% vs 25%), and 1 month (7.7% vs 23.5%) compared to the CG.
• Mean highest pain intensity was lower in the IG (2.17±2.07) versus CG (3.53±2.69) at 2 hours post-PCI.
• Statistically significant differences in pain intensity were observed favoring the IG throughout the follow-up period.

Conclusions:

• The MPM approach effectively reduces both the prevalence and intensity of arm-shoulder pain following PCI.
• Further randomized controlled studies are warranted to confirm these findings and explore broader applications.