Effect of the head of bed elevation on back pain after elective coronary angiography: A randomized controlled trial

Abstract

BackgroundPatients 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. AimWe aimed to investigate the effect of the head of bed (HOB) elevation on back pain and vascular complications after elective CAG. MethodsThree 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. ResultsMean 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 ConclusionsElevation of the HOB to 30 degrees was associated with decreased back pain level without increased risk of vascular complications.