Effect of Ice Bag Application to Femoral Region on Pain and Vital signs in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Randomized Controlled Trial

Abstract

Background: Patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) experience a great deal of pain and discomfort in the femoral region induced by femoral catheter removal, which can stimulate the sympathetic system and affect some vital signs. Objective: The aim of this study was to determine the effect of ice bag application to femoral region on pain and vital signs in patients with acute MI undergoing PCI. Methods: This is a double-blind randomized controlled trial study. The sample of this study consisted of 60 patients with acute MI undergoing PCI, including 30 patients per group, selected by convenience sampling method and assigned to intervention and control groups by block randomization method. The intervention included the use of an ice bag in the femoral catheter insertion site. Data collection tools included demographic information form, Numerical Rating Scale (NRS), and vital signs form. Femoral site pain and vital signs were measured in both groups before, during, and after femoral catheter removal. The data were entered into SPSS ver. 22. Using descriptive statistics, Chi-square and Mann Whitney test, data were analyzed. Results: Two groups were matched in terms of all demographic and disease-related variables (p>0.05). Pain score was lower in intervention group than in control group during and after the intervention (p<0.0001). Also, systolic, diastolic blood pressure, and temperature scores of the patients in the intervention group were significantly lower than the control group during and after catheter removal (p<0.05). Respiratory rate of the intervention group was significantly lower than the control group (p = 0.005). No significant difference between the two groups in the mean of heart rate in all three time periods (p>0.05). Conclusion: Application of the ice bag on the femoral region is effective in stabilizing the vital signs and decreasing the pain caused by femoral catheter removal in MI patients undergoing PCI. Therefore, considering its low cost and complications, topical application of an ice bag, as a nursing intervention to control the pain and keep stable vital signs, is recommended. Clinical Trial Registration No: IRCT201511070249191N7.