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Effect of the head of bed elevation on back pain after elective coronary angiography: A randomized controlled trial
Sevda Türen1, Rahime Atakoğlu Yilmaz1, Nezahat Yesiltepe2
1Department of Nursing, Faculty of Health Sciences, T.C. Istanbul Kültür University, Istanbul, Turkey.
Insights
Elevating the head of the bed (HOB) to 30 degrees after coronary angiography (CAG) significantly reduces patient back pain. This HOB elevation does not increase the risk of vascular complications, offering a more comfortable recovery.
Area of Science:
- Cardiology
- Medical Procedures
- Patient Recovery
Background:
- Patients undergoing coronary angiography (CAG) experience significant back pain due to mandatory flat bed rest.
- This prolonged immobility is a measure to prevent potential vascular complications post-procedure.
Purpose of the Study:
- To evaluate the impact of head of bed (HOB) elevation on post-coronary angiography back pain.
- To determine if HOB elevation affects the incidence of vascular complications after elective CAG.
Main Methods:
- A randomized controlled trial involving 307 patients undergoing elective CAG.
- Patients were assigned to three groups: flat (0 degrees HOB), 15 degrees HOB, or 30 degrees HOB.
- Back pain was quantified using a visual analog scale at specified time points.
Main Results:
- Patients in the 15 and 30 degrees HOB groups reported significantly less back pain at 3 and 6 hours compared to the flat group.
- A higher HOB elevation (30 degrees) correlated with lower pain scores than a 15-degree elevation.
- HOB elevation to 30 degrees was identified as an independent predictor of reduced pain, with only one minor bleeding event in the 0-degree group.
Conclusions:
- Elevating the head of the bed to 30 degrees effectively alleviates back pain following coronary angiography.
- This simple intervention does not elevate the risk of vascular complications, improving patient comfort and recovery.
Background:
Patients are restricted to bed and required to lie flat after coronary angiography (CAG) due to potential risk of vascular complications. This often causes back pain.
Aim:
We aimed to investigate the effect of the head of bed (HOB) elevation on back pain and vascular complications after elective CAG.
Methods:
Three hundred and seven consecutive patients who underwent elective CAG were randomized into three groups. One control (HOB: 0 degree-flat position) and two experimental (HOB: 15 and 30 degrees) groups were compared. Back pain level was assessed using a visual analog scale.
Results:
Mean age was 58.1±10.7, and 59.9% (n=184) of the patients were males. Pain level at the 3rd hour and at the 6th hour was significantly higher in the control group than in the experimental groups. In the post-hoc analysis, pain level was significantly higher in HOB 15 degrees compared to that in HOB 30 degrees. In the multivariate analysis, HOB elevation to 30 degree was the only independent predictor of the pain level at the 3rd hour and the 6th hour. Only one patient in the HOB 0 degree group had a minor bleeding at the access site CONCLUSIONS: Elevation of the HOB to 30 degrees was associated with decreased back pain level without increased risk of vascular complications.
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