The effect of cold compress on alleviating pain from Enoxaparin injection in cardiovascular patients: A randomized controlled trial

Background: Enoxaparin, a low-molecular-weight heparin used in cardiac patients to prevent thromboembolism, often causes injection-site pain, contributing to patient discomfort and anxiety. Non-pharmacological interventions like cold compresses may mitigate this pain.Objective: This study aimed to evaluate the effect of a cold compress on alleviating pain caused by enoxaparin injection in cardiovascular patients.Methods: This randomized, double-blind, controlled trial was conducted at Shahid Beheshti Hospital, Kashan, Iran, in ۲۰۱۸. Fifty cardiovascular patients prescribed enoxaparin were randomly assigned to a cold compress group (n=۲۵) or a control group (n=۲۵). All participants received two enoxaparin injections: the first served as a baseline (no intervention), and the second was administered with or without the cold compress. The cold compress group had a ۵-minute application of a standardized ice pack before the second injection. Pain intensity was measured immediately and ۵ minutes post-injection using the Visual Analog Scale (VAS).Results: Baseline pain scores were similar between the cold compress and control groups (p>۰.۰۵). An Analysis of Covariance (ANCOVA), controlling for baseline pain, revealed that the cold compress group reported significantly lower pain immediately after the second injection (adjusted M=۴.۴, ۹۵% CI: ۳.۷ to ۵.۱) compared to the control group (adjusted M=۵.۶, ۹۵% CI: ۴.۹ to ۶.۳; p=۰.۰۱). A similar significant reduction was observed at ۵ minutes post-injection (adjusted M=۳.۹, ۹۵% CI: ۳.۳ to ۴.۶ vs. adjusted M=۵.۳, ۹۵% CI: ۴.۶ to ۵.۹; p=۰.۰۱).Conclusion: The application of a cold compress significantly reduces pain associated with enoxaparin injections. This finding supports the use of a cold compress as a simple, effective, and non-pharmacological intervention for improving patient comfort in cardiac care.

Keywords:

Cold compress , Enoxaparin , Pain management , cardiac patients , Non-pharmacological intervention