Controlled trial of backrest elevation after coronary angiography

Abstract

BACKGROUND: Protocol at most centers requires keeping the head of the bed flat for at least 5.5 hours after coronary angiography. OBJECTIVE: To determine the effect of head of bed elevation after diagnostic coronary angiography on patient comfort and on the incidence and timing of postprocedural complications. METHODS: A convenience sample of 120 adult patients on the short-stay special procedures nursing unit of a university teaching hospital was used. Patients who had undergone elective diagnostic coronary angiography via the femoral artery were randomly assigned to a control or experimental group. The control group had the head of bed maintained at 15 degrees or less for 5.5 hours after the procedure. The experimental group had the head of bed gradually elevated from 15 degrees to 60 degrees over the 5.5 hours. Both groups dangled and ambulated after 5.5 hours. All other aspects of the procedure were identical. Outcome was measured by incidence and timing of dizziness, hypotension, bleeding, hematoma, and diminished foot pulses. Level of pain was assessed on a scale of 0 to 10. RESULTS: No statistically significant differences were noted between groups in the incidence of complications. The incidence of back pain at a level of more than 3 on a scale of 0 to 10 was less for the experimental group than for the control group. CONCLUSIONS: Elevation of the head of the bed after coronary angiography decreases discomfort with no increase in complications. Replication of this study is needed for verification.