Effectiveness of mechano-analgesia and cold application on ecchymosis, pain, and patient satisfaction associated with subcutaneous heparin injection

• Published in: Journal of vascular nursing 2020-06, Vol.38 (2), p.76-82
• Main Authors: Inangil, Demet, Şendir, Merdiye
• Format: Article
• Language: English
• Subjects: Analgesia; Anticoagulants - administration & dosage; Cryotherapy; Ecchymosis; Female; Heparin - administration & dosage; Humans; Injections, Subcutaneous; Male; Middle Aged; Nursing; Pain; Pain Management; Patient Satisfaction; Prospective Studies; Surveys and Questionnaires; Turkey
• ISSN: 1062-0303; 1532-6578
• DOI: 10.1016/j.jvn.2020.02.002

The purpose of this study was to investigate the effect of mechano-analgesia and cold application on subcutaneous heparin injection ecchymosis, pain, and patient satisfaction. This was a prospective, controlled, quasi-experimental, and clinical research. The study was conducted during a 10-month period in the Orthopedics and Traumatology wards of a university hospital in Istanbul, Turkey. The 55 patients received 3 subcutaneous heparin injections (165 injections) by the same investigator using additional techniques such as mechano-analgesia and cold application, and without any additional techniques. ShotBlocker for the mechano-analgesia and an ice pack for the cold application were used. Pain and ecchymosis are different according to individual features. Therefore, subcutaneous heparin was administered to the same patients by using 3 different methods. Pain and satisfaction were assessed immediately after the injection by using the visual analog scale. Ecchymosis was assessed with an ecchymosis measurement tool (Opsite FlexiFix) at 48 and 60 hours after the injection. Research findings show that ecchymosis occurred in 6.6% of all injections. The lowest and smallest ecchymosis occurred in cold application, but the difference was not statistically significant among the techniques (P = .178). Use of mechano-analgesia and cold application reduce pain (P = .00). Mechano-analgesia was ineffective for ecchymosis while reducing pain. The satisfaction level was highest with mechano-analgesia, with statistically significant differences among the techniques (P = 0.001). Mechano-analgesia and cold application can be effective in reducing injection pain and increasing patient satisfaction. •The local side effects of subcutaneous heparin administration are ecchymosis and intense pain at the injection site.•Ecchymosis can be prevented when correct injection techniques are applied.•The mechano-analgesia and cold application can be effective in decreasing subcutaneous heparin injection pain and increasing patient satisfaction.