Evaluation of the effect of premedication on pain severity and hemodynamic status of patients undergoing coronary angiography

Background: As a stressful invasive procedure, angiography causes pain and several hemodynamic changes in patients. Various forms of premedication are used to reduce these complications; however, there is no consensus on their effectiveness. This study aimed to determine the effect of premedication on pain severity and hemodynamic status of patients undergoing coronary artery angiography.

Methods: This clinical trial was conducted on candidates for coronary angiography, who referred to Ganjavian Hospital of Dezful, Iran, in 2012. In total, 102 patients were selected through convenience sampling and randomly divided into three groups of 34 cases. The first group was intravenously administered 4 mg of chlorpheniramine, whereas the second and third groups were intravenously injected 5 mg of diazepam and 2 mg of normal saline, respectively, 30 minutes before angiography. Pain intensity and hemodynamic status of the patients were evaluated and recorded before, during, and after angiography. Data collection was carried out using visual analogue scale and hemodynamic status registration form. Data analysis was performed in SPSS, version 19, using Chi-square, One-way analysis of variance (ANOVA), Friedman, Kruskal-Wallis, and repeated measures ANOVA.

Results: In this study, pain increased in all the three groups after angiography (P<0.001); however, this difference between the groups was not significant. On the other hand, heart rate, blood pressure, and respiratory rate decreased after the angiography (P<0.001). This difference was only significant regarding systolic (P=0.03) and diastolic (0.02) blood pressures and heart rate (P=0.04) of patients on the fourth 15 minutes after the angiography.

Conclusion: According to the results of this study, no significant difference was observed between the groups in terms of the effect of different types of premedication on pain severity and hemodynamic status. Future studies are recommended to evaluate the effect of premedication during other invasive procedures.