Decreasing length of limb immobilisation following nonelective transfemoral percutaneous coronary intervention: A randomised clinical trial.

Abstract

To assess the intensity and frequency of pain, use of analgesic drugs, and the incidence of paraesthesia, urinary retention and vascular complications upon decreasing affected limb immobilisation from 4-2hrs after sheath removal in patients submitted to transfemoral percutaneous coronary intervention (PCI). After sheath removal from the femoral artery following urgent or emergency PCI, patients are maintained with limb immobilisation for a mean period of 4hr. Randomised clinical trial (RCT) based on the CONSORT guidelines. Randomised clinical trial was performed in patients with Acute Coronary Syndrome submitted to transfemoral PCI. The intervention group was submitted to a supine position with theheadof the bed elevated (30-degree angle) with affected limb immobilisation for 2hr after sheath removal and the control group for 4hrs. The outcomes were pain complaints, need for analgesic drugs, incidence of paraesthesia, urinary retention and vascular complications. The outcomes were assessed immediately, 6, 12 and 24hr after release from limb immobilisation before the patients were released from bed rest. A total of 150 patients (75 in each group) participated in the study. No significant differences in outcomes were observed between the groups, except in relation to the haematoma formation that was higher in the intervention group. A reduced length of limb immobilisation after sheath removal following PCI does not change the frequency and intensity of pain, need of analgesic drugs, urinary retention and paraesthesia. The incidence of haematoma was higher in the intervention group, without significant clinical manifestations. The results of this study can be considered for patients submitted to elective, urgent or emergency PCI, who have a lower risk of complications, thereby allowing for decreased periods of limb immobilisation.