The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design

OBJECTIVE: To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection (SCAI) on pain intensity and hematoma formation. METHODS: A quasi-experimental design was utilized. A convenient sample of 105 adult patients, who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI, were recruited over a period of six months. Patients were randomly allocated into three groups: A Control group who received the routine hospital care (G1,n = 35) and two intervention group who received cryotherapy for 5-min (G2: cryotherapy applied before SCAI, n = 35; G3: cryotherapy applied after SCAI, n = 35). Demographic and medical history data sheet, Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data. RESULTS: The pain intensity among the patients in the two intervention groups (G2: Median = 1.0; G3: Median = 0) was significantly lower than in the control group (G1, Median = 3.0). No significant difference was found between G2 and G3(P = 0.728). Applying cryotherapy after SCAI (G3) decreased the frequency of hematoma formation (48hrs = 31.4% & 72hrs = 28.5%) compared to applying it before injection (G2, 100%) or not applying it (G1, 100%). The size of hematoma in G3 was smaller than that in G2 (P < 0.01). CONCLUSION: Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size. Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.