Abstract
Methods 137 patients who underwent PCI procedure via radial artery were randomly assigned (1 : 1) to the control (CG, n = 68) and intervention (IG, n = 65) groups. IG received MPM (paracetamol, ibuprofen, and the arm physiotherapy), CG received pain medication “as needed.” Outcomes were assessed immediately after, 2, 12, 24, and 48 h, 1 week, and 1 and 3 months after PCI. The primary outcome was A-S pain prevalence and pain intensity numeric rating scale (NRS) 0–10. Results Results showed that A-S pain prevalence during the 3-month follow-up period was decreasing. Statistically significant difference between the groups (CG versus IG) was after 24 h (41.2% versus 18.5, p=0.005), 48 h (30.9% versus 1.5%, p ≤ 0.001), 1 week (25% versus 10.8%, p=0.042), 1 month (23.5% versus 7.7%, p=0.017) after the procedure. The mean of the highest pain intensity was after 2 h (IG-2.17 ± 2.07; CG-3.53 ± 2.69) and the lowest 3 months (IG-0.02 ± 0.12; CG-0.09 ± 0.45) after the procedure. A-S pain intensity mean scores were statistically significantly higher in CG during the follow-up period (Wilks' λ = 0.84 F (7,125) = 3.37, p=0.002). Conclusion In conclusion, MPM approach can reduce A-S pain prevalence and pain intensity after PCI. More randomized control studies are needed.
Highlights
Ischemic heart disease (IHD) is one of the leading causes of sudden death
E control group (CG) received pain relief in a ‘as needed’ regime and it was provided by a cardiologist who was taking care of the patient after the Percutaneous cardiac intervention (PCI) according to the department pain management practice
A-S pain after PCI is mentioned in several articles and the problem has been identified in the acute period when the prevalence of severe pain is up to 9.8% [18,19,20,21,22]. is postprocedure pain can be described as a complication associated with the PCI procedure. e mechanism of the A-S pain involves the periprocedural period
Summary
Ischemic heart disease (IHD) is one of the leading causes of sudden death. Percutaneous cardiac intervention (PCI) is a gold standard to treat IHD. E TR approach is associated with lower complication rate and better early and long-term outcomes [1]. Complications such as arterial bleeding, hematoma formation, pseudoaneurysm, or limb dysfunction have been reported in the literature [2, 3]. 1 in 20 patients undergoing PCI experience acute procedure-related A-S pain [5]. Development of chronic pain is associated with many factors, but the most important is severe pain intensity for 24 hours after the intervention and the duration of how long the patient was in pain [7,8,9,10,11]. Pain Research and Management complications associated with their use [13]. We hypothesize that the MPM model will reduce the intensity of pain, the occurrence of pain in patients with CHD after a coronary angiography procedure performed through the radial artery
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