Pain relief for femoral sheath removal in interventional cardiology patients

Nursing Care Practices Following a Percutaneous Coronary Intervention

“…13 Sheath Removal Discomfort Management A range of preferences for managing femoral sheath removal discomfort was evident. 16,17 The findings from our study indicate that nurses have varying practice preferences and that their preferences, for milder forms of analgesia with or without sedation, have not been adequately studied or supported by research evidence. To improve patient outcomes, fur-ther investigation into appropriate patterns of sheath removal pain management is required.…”

“…16 Furthermore, the authors concluded that the use of local anesthetic in-creased the risk of vasovagal events and therefore should be avoided, 16 in keeping with findings from an earlier study. 14 A systematic review undertaken by Wensley and colleagues 17 concluded that data were insufficient to identify the influence of pain management on patient outcomes. These authors identified the challenges in interpreting data because of inadequate blinding.…”

Comparison of Radial and Femoral Approaches for Coronary Angiography with or without Percutaneous Coronary Intervention in Relation to Vascular Access Site Complications

“…In Ang, et al's study, fentanyl and midazolam were administered routinely which may have positively impacted on their results. Wensley, Kent, Price and Stewart (2006) have written a protocol for a systematic review on pain relief for femoral sheath removal in interventional cardiology patients. They will be collating all the information found in randomised controlled trials (RCT) in relation to pain perception of patients when undergoing the femoral sheath removal.…”

“…Even some medicated patients experience pain and discomfort to a lesser degree. According to Wensley, et al, (2006) this may be due to the sheath removal itself or the pressure that is applied for haemostasis post removal of sheath.…”

“…Internationally, the current practice in regards to the use of analgesia for the relief of pain prior to removal of sheath varies considerably. A survey within Wensley, et al (2006) Vasovagal reactions which involve symptomatic bradycardia and hypotension are a common complication following coronary intervention. Ang, et al, (2005) identified common predictors of vasovagal events; a higher pain score from the Visual Analogue Scale (VAS), a lower BMI, receiving a glyceryl trinitrate infusion and the left anterior 18 descending artery as the treated vessel.…”