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Decreasing length of limb immobilization following non-elective transfemoral percutaneous coronary intervention: a randomized clinical trial.

Research paper by Vinicius Batista VB Santos, Luize Máximo E LME Melo, Ana Raquel Viegas ARV de Assis, Juliana Brito JB de Moraes, Camila Takao CT Lopes, Juliana J de Lima Lopes, Alba Lucia Bottura Leite ALBL de Barros

Indexed on: 13 Jun '19Published on: 03 Apr '19Published in: Journal of Clinical Nursing



Abstract

After sheath removal from the femoral artery following urgent or emergency percutaneous coronary intervention (PCI), patients are maintained with limb immobilization for a mean period of four hours. To assess the intensity and frequency of pain, use of analgesic drugs, and the incidence of paresthesia, urinary retention and vascular complications upon decreasing affected limb immobilization from four to two hours after sheath removal in patients submitted to transfemoral PCI. Randomized clinical trial (RCT) based on the CONSORT guidelines. RCT was performed in patients with ACS submitted to transfemoral PCI. The Intervention Group was submitted to a supine position with the head of the bed elevated (30-degree angle) with affected limb immobilization for two hours after sheath removal and the Control Group for four hours. The outcomes were pain complaints, need for analgesic drugs, incidence of paresthesia, urinary retention and vascular complications. The outcomes were assessed immediately, 6, 12 and 24 hours after release from limb immobilization before the patients were released from bed rest. 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 hematoma formation that was higher in the intervention group. A reduced length of limb immobilization after sheath removal following PCI does not change the frequency and intensity of pain, need of analgesic drugs, urinary retention, and paresthesia. The incidence of hematoma 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 immobilization. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.