Effect of Cold Application on Pain, Ecchymosis, and Comfort After Transradial Coronary Angiography

Summary

This randomized controlled experimental study aimed to examine the effect of cold application after transradial coronary angiography on pain, bruising (ecchymosis), and comfort levels in patients.

The study was conducted in the coronary intensive care unit of a university hospital in Istanbul, Türkiye, between July 2023 and July 2024. A total of 104 adult patients who underwent transradial coronary angiography were randomly assigned to intervention (cold application) and control groups using a computer-based randomization method.

In the intervention group, cold packs were applied to the wrist starting immediately after admission to the coronary intensive care unit. Cold application was performed for 15 minutes every hour until the TR band was removed and then every 2 hours for 15 minutes afterward. The control group received routine care without cold application.

Pain levels were assessed hourly using the Numerical Rating Scale (NRS). Bruising was monitored by measuring hematoma size, and patient comfort was evaluated at two time points: at admission and when the TR band was removed, using the Early Postoperative Comfort Scale. The primary outcomes were pain, ecchymosis, and comfort levels. The secondary outcome was the duration of TR band placement.

The study aimed to determine whether cold application helps reduce pain and bruising and improves comfort after transradial coronary angiography.

Conditions

• Coronary Artery Disease

Interventions

OTHER

Standard Post-Procedural TR Band Care

Protocolized hemostasis management following transradial coronary angiography included TR Band balloon deflation by 2-3 mL every 15 minutes during the first hour, followed by deflation at 30-minute intervals until the balloon was fully emptied. If bleeding occurred, the withdrawn air was immediately reinjected to restore hemostasis. The TR Band was removed once bleeding had stopped, and a sterile gauze dressing was applied. Participants received routine monitoring for bleeding and vascular complications. No cold application was administered.

OTHER

Cold Application

Gel cold packs, pre-frozen for 2-3 hours, were applied to the wrist at the transradial puncture site for 15 minutes every hour, beginning immediately after admission to the coronary intensive care unit and continuing until TR Band removal. Cold application was administered in addition to standard post-procedural TR Band care and did not extend beyond the 6-hour follow-up period.

Sponsors & Collaborators

• Istanbul University

  collaborator OTHER

• Bezmialem Vakif University

  lead OTHER

Principal Investigators

• Şeymanur Gökce ÇIŞAN · Adnan Menderes Bulvarı (Vatan Cad.) P.K. 34093 Fatih / İstanbul

• Gülsün Özdemir Aydın, PhD · Istanbul University Faculty of Nursing

• Türkinaz Aştı, Professor · Esentepe Mahallesi, Silahtarağa Caddesi No:189 (İğdaş Genel Müdürlüğü Karşısı) Eyüpsultan / İSTANBUL

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-01-31

Primary Completion

2025-01-30

Completion

2025-02-28

Countries

• Turkey (Türkiye)

Study Locations