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A Randomized Controlled Trial on Position Change followed by early Ambulation after Trans-Femoral Coronary Angiography
Background and Aim : Femoral route is a common approach for doing coronary angiography, but bed rest is recommended due to risk of vascular complications. The aim of present study was to assess effect of position change followed by early ambulation after coronary angiography via femoral approach on comfort, fatigue and vascular complications of the patients. Subjects and Methods: A randomized controlled trial was conducted on 80 patients (40 each in control and experimental group) undergoing coronary angiography in a tertiary care institute in India. Patients in control group were placed in supine position and ambulated after 6 hours. Experimental group were kept in supine position for 2 hours after angiography, followed by right lateral position (1 hour), supine position (1 hour) and ambulated after 4 hours. Kolcaba’s Outcome was assessed using General Comfort Questionnaire, Numerical pain rating scale and Fatigue Visual Numeric Scale at 2, 4, 6 and 24 hours after angiography. Incidence of vascular complications was documented at 24th hours. Results: At 4th and 6th hours after angiography, fatigue experienced by experimental group was significantly lower than control group. At 6th and 24th hour, experimental group had significantly lesser back pain and better comfort. There was no significant difference in the incidence of vascular complications between the control and experimental groups. Conclusion: Position change followed by early ambulation after coronary angiography via femoral approach is safe and effective as it decreases back pain, fatigue and improve comfort without increasing vascular complications.
Bed Rest, Cardiac Catheterization, Coronary Angiography, Early Ambulation, Position Change, Cardiac Nursing.
- Moradpour F, Moeini M, Khosravi, Ranjbar S. Effect of out of bed after sheath removal angioplasty in Shhid Chamran Hospital in 2007. Cardiac nurses, physiotherapists and perfusionists of the 16th congress of Iranian Heart Association in collaboration with American College of Cardiology. 2008. p. 107.
- Chair SY, Taylor-Piliae RE, Lam G, Chan S. Effect of positioning on back pain after coronary angiography. Journal of Advanced Nursing 2003; 42:470-8.
- Chair SY. Effect of early ambulation after cardiac catheterization. Thesis Doctor of Philosophy. University of Colorado; 2004. p. 21-4.
- Chair SY, Yu M, Choi KC, Wong EM, Sit JW, Ip WY. Effect of early ambulation after transfemoral cardiac catheterization in Hong Kong: a single-blinded randomized controlled trial. Anatolian Journal of Cardiology 2012;12:222-30.
- Chair SY. Early mobilisation after transfemoral catheterisation is not associated with increased vascular incidents, and reduces back pain. Evidence Based Nursing 2014;18:20.
- Keeling A, Taylor V, Nordt LA, Powers E, Fisher C. Reducing time in bed after cardiac catheterization. American Journal of Critical Care 1996; 5:277-81.
- Lau KW, Tan A, Koh TH, Koo CC, Quek S, Ng A, et al. Early ambulation following diagnostic 7 French cardiac catheterization: A prospective randomized trial. Catheterization Cardiovascular Diagnosis 1993; 28:34-8.
- Sabzaligol M, Shariat E, Varaei SH, Mahran A, Bassampour SH. The effect of changing position and early ambulation after cardiac catheterization on back pain and bleeding. HAYAT 2009;15:60.
- Ashketorab T, Neishabory N, Ghezelghash A, Piranfar A, Alavi Majd H. Effects of change position in bed on vascular complications after coronary angiography. Journal of Shahid Beheshti School of Nursing and Midwifery 2007;17:1-10.
- Kolyaee MN, Ebadi A. Effects of change position on back pain and vascular complications after coronary angiography. Iranian Journal of Nursing Research 2007; 1:41-5.
- Rezaei-Adaryani M, Ahmadi F, Mohamadi E, Asghari-Jafarabadi M. The effect of three positioning methods on patient outcomes after cardiac catheterization. Journal of Advanced Nursing 2008; 65: 417-24.
- Boztosun B, Gunes Y, Yildiz A, Bulut M, Saglam M, Kargin R, et al. Early ambulation after diagnostic heart catheterization. Angiology 2007; 58:743-6.
- Mohammady M, Heidari K, Sari AA, Zolfaghari M, Janani L. Early ambulation after diagnostic transfemoral catheterisation: a systematic review and meta-analysis. International Journal of Nursing Studies 2014; 51: 39-50.
- Tagney J, Lackie D. Bed-rest post-femoral arterial sheath removal-What is safe practice? A clinical audit. Nursing in Critical Care 2005; 10: 167-73.
- Farmanbar R, Mohammadiyan MA, Moghaddamniya MT, Kazemnejad E, Salari A. The effect of position change and bedrest duration after coronary angiography on vascular complications. Iranian Journal of Critical Care Nursing 2012; 4:177-82.
- Pooler-Lunse C, Barkman A, Bock BF. Effects of modified positioning and mobilization of back pain and delayed bleeding in patients who had received heparin and undergone angiography: a pilot study. Heart Lung 1996; 25:117-23.
- McCaffery M, Pasero C. 0-10 Numeric Pain Rating Scale. Pain: Clinical Manual for nursing practice, 2nd edition. St. Louis, MO: Mosby; 1999. p. 16.
- Kolcaba K. Comfort Theory and Practice: A Vision for Holistic Health Care and Research, 1st edition. New York: Springer Publishing Company; 2003.
- Ritter PL, Gonzalez VM, Laurent DD, Lorig KR. Measurement of Pain Using the Visual Numeric Scale. Journal of Rheumatology 2006; 33:574-80.
- Mahak C, Shashi Y, Hemlata NM, Sandhya G, Dheeraj K, Dhandapani M, Dhandapani SS. Assessment of utilization of rehabilitation services among stroke survivors. Journal of neurosciences in rural practice. 2018 Oct; 9(4):461.
- Dhandapani S, Goudihalli S, Mukherjee KK, Singh H, Srinivasan A, Danish M, et al. Prospective study of the correlation between admission plasma homocysteine levels and neurological outcome following subarachnoid hemorrhage: A case for the reverse epidemiology paradox?. Acta neurochirurgica. 2015 Mar 1; 157(3): 399-407..
- Dhandapani S, Aggarwal A, Srinivasan A, Meena R, Gaudihalli S, Singh H, Dhandapani M, Mukherjee KK, Gupta SK. Serum lipid profile spectrum and delayed cerebral ischemia following subarachnoid hemorrhage: Is there a relation?. Surgical neurology international. 2015; 6(Suppl 21):S543.
- Bogart MA, Bogart DB, Rigden LB, Jung SC, Liston MJ. A prospective randomized trial of early ambulation following 8 French diagnostic cardiac catheterization. Catheterization and Cardiovascular Interventions 1999; 47:175-8.
- Burn KL, Marshall B, Scrymgeour G. Early mobilization after femoral approach diagnostic coronary angiography to reduce back pain. Journal of Radiology Nursing. 2015 Sep 1; 34(3):162-9.
- Keeling AW, Knight E, Taylor V, Nordt LA. Post-cardiac catheterization time-in-bed study: enhancing patient comfort through nursing research. Applied Nursing Research 1994; 7:14-7.
- Dhandapani S, Gupta A, Singh J, Sharma BS, Mahapatra AK, Mehta VS. Spinal dural arterio-venous fistula: Clinico-radiological profile and outcome following surgical occlusion in an Indian neurosurgical center. Neurology India. 2013 Jul 1;61(4):406.
- Dhandapani SS, Manju D, Vivekanandhan S, Agarwal M, Mahapatra AK. Prospective longitudinal study of biochemical changes in critically ill patients with severe traumatic brain injury: Factors associated and outcome at 6 months. Indian Journal of Neurotrauma. 2010 Jun;7(01):23-7.
- Fowlow B, Price P, Fung T. Ambulation after sheath removal: A comparison of 6 and 8 hours of bed rest after sheath removal in patients following a PTCA procedure. Heart Lung 1995;24:28-37.
- Farasyn A, Meeusen R. The influence of non-specific low back pain on pressure pain thresholds and disability. European Journal of Pain 2005;9:375-81.
- Dhandapani M, Dhandapani S, Agarwal M, Mahapatra AK. Pain perception following different neurosurgical procedures: a quantitative prospective study. Contemporary Nurse 2016;52:47785.
- Dave K, Qureshi A, Gopichandran L. Effects of Earplugs and Eye Masks on Perceived Quality of Sleep during Night among Patients in Intensive Care Units. Asian Journal of Nursing Education and Research 2015;5:319.
- Dhandapani M, Gupta S, Mohanty M, Gupta SK, Dhandapani S. Prevalence and trends in the neuropsychological burden of patients having intracranial tumors with respect to neurosurgical intervention. Annals of neurosciences. 2017;24(2):105-10.
- Rajan D, Lakshmanan G, Gupta SK, Sivasubramanian R, Saxena A, Juneja R. Effect of Recorded Maternal Voice on Child's Cooperation During Cardiac Catheterization- A randomized controlled trial. Indian Pediatrics 2017;54:204-7.
- Dhandapani S, Singh A, Singla N, Praneeth K, Aggarwal A, Sodhi HB, Pal SS, Goudihalli S, Salunke P, Mohindra S, Kumar A. Has Outcome of Subarachnoid Hemorrhage Changed With Improvements in Neurosurgical Services? Study of 2000 Patients Over 2 Decades From India. Stroke. 2018 Dec;49(12):2890-5.
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