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      Effect of change in patient's bed angles on pain after coronary angiography according to vital signals

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          Abstract

          Background:

          One of the most common and important diagnostic methods for the detection of heart diseases is coronary angiography. The aim of this study was to determine the optimum angle of the bed by using vital signals to optimize the patient's position after the angiography.

          Materials and Methods:

          This study was a randomized clinical trial (RCT) on participants after angiography who were divided into five groups. The first group was placed routinely in a supine position. In the other groups, all of the patients were placed in bed by angle 15°, 30°, 45°, and 60° upward. In each group, vital signals were measured that included blood pressure, percent of blood oxygen saturation, heart rate, respiratory rate, and temperature. All of measured data compared with the pain score has been achieved from numerical pain scale. The data were analyzed by descriptive statistics method, variance analysis, and post hoc tests in the Statistical Package for the Social Sciences (SPSS) software, version 16. Estimation of the relationship was done by MATLAB version 2011. The level of significance was considered to be 0.05.

          Results:

          In various groups, there was no significance difference in demographic variables such as gender, age, height, and weight. The mean of pain score, heart rate, systolic blood pressure, and respiratory rate changed significantly ( P < 0.05) but the temperature variation, blood oxygen saturation, and diastolic blood pressure in subjects were not significant ( P > 0.05). It showed linear changes between pain and systolic blood pressure, respiratory rate, and heart rate changes. A dramatic reduction was also seen in systolic blood pressure, respiratory rate, heart rate, and also pain at an angle of 45 °.

          Conclusion:

          This study showed that, 45 ° was the best angle of the bed to optimize the patient's position after the procedure, based on his/her vital signs and pain score. Thus, in order to relive pain, this change in bed angle is advised to be planned by postangiography nurses in patients after coronary angiography.

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          Most cited references23

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          The information needs of patients treated with primary angioplasty for heart attack: an exploratory study.

          As early recovery is a challenging period for cardiac patients who frequently have 'unmet' health information needs, the objective of this study was to explore the information needs of patients treated with primary angioplasty for heart attack. Qualitative methodology using semi-structured interviews with 29 patients recruited from a specialist English Cardiology centre, 3-12 days after discharge from hospital. Framework analysis techniques were used to synthesise findings. Participants were generally satisfied with the way in which health information was provided. The need for more specific information about the risk of recurrence, the level of heart muscle damage, discharge medications, appropriate levels of physical activity and diet was highlighted. There was no clear preference for informant and preferences for the timing of information delivery varied considerably. Health information provision was satisfactory for most but could be improved by the closer matching of patients' preferences with provision. The shortened hospital stay, rapid throughput and emotional shock experienced by patients influenced their ability to absorb information making the optimum timing for health information delivery variable. Current guidelines about the provision of health information for patients recovering from heart attack may need to be reviewed to reflect the recent technological advances in treatment. One approach may be to better 'stage' information to reflect patients' priorities. Home visits by specialist nurses may need to be scheduled earlier to improve continuity of care and address information 'gaps'.
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            Effects of acute postoperative pain on catecholamine plasma levels, hemodynamic parameters, and cardiac autonomic control.

            Postoperative pain is often stated to be a significant contributor to a sympathetic stress response after surgery. However, hardly any evidence has been published to support this assumption. Hence it was the aim of this trial to investigate the relationship between postoperative pain and hemodynamic, endocrine, and autonomic parameters. A total of 85 postoperative patients in the recovery room were repeatedly asked to rate their pain on a numeric rating scale (NRS). Concurrently, the parameters of heart rate variability (HRV) were analysed, and mean arterial pressure (MAP), heart rate (HR) and respiration rate (RR) were recorded. Pain was categorized into no, mild, moderate, and severe. Blood samples were taken for epinephrine (EPI) and norepinephrine (NE) plasma level assessment at the time of recovery room admission and discharge, and each time pain was found decreased in categorized severity. A total of 239 pain readings were obtained. None of the investigated parameters correlated with NRS scores. NE was higher at NRS 5 to 10 vs. NRS 0 to 4 (mean [SEM]: 1009 [73] pg/mL vs. 872 [65] pg/mL; P<0.01). This was also found for MAP, but not for EPI or the parameters of HRV, HR, and RR. In contrast to common belief, the severity of postoperative pain does not appear to be associated with the degree of sympathetic stress response after surgery, and other factors such as surgical trauma may be more important. Importantly, the absence of signs of sympathetic stimulation cannot be seen as a guarantee for the absence of significant pain. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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              The effect of ambulation after cardiac catheterization on patient outcomes.

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                Author and article information

                Journal
                J Res Med Sci
                J Res Med Sci
                JRMS
                Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                1735-1995
                1735-7136
                October 2015
                : 20
                : 10
                : 937-943
                Affiliations
                [1]Department of Basic Sciences, Medicine School, North Khorasan University of Medical Sciences, Bojnurd, Iran
                [1 ]Department of Cardiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
                [2 ]Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
                Author notes
                Address for correspondence: Mohsen Yaghubi, 9Day Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. E-mail: n.m.yaghubi@ 123456gmail.com
                Article
                JRMS-20-937
                10.4103/1735-1995.172767
                4746866
                26929757
                b9e3419a-f4fc-4698-a7db-3a81f0bff2fb
                Copyright: © Journal of Research in Medical Sciences

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 11 June 2014
                : 24 February 2015
                : 01 October 2015
                Categories
                Original Article

                Medicine
                coronary angiography,pain,pain score,bed position,vital signals
                Medicine
                coronary angiography, pain, pain score, bed position, vital signals

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