Document Type : Case Study
Authors
1
School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
2
Department of Medical Emergencies, School of Allied Medical Sciences Kermanshah University of Medical Sciences, Kermanshah, Iran
3
Department of Persian Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4
Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran
5
Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
6
Department of Medical Emergencies, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Background: Nitroglycerin is a vital medication in cardiac intensive care units,
but headache induced by it is a common and distressing complication that can
lead to reduced patient cooperation and even treatment discontinuation.
Acupressure at point P6 considered a non-pharmacological, safe, and cost-
effective method. This study aimed to determine the effect of pressure band on
point P6 on the prevention of nitroglycerin infusion-induced headache in
patients hospitalized in the cardiac intensive care unit.
Methods: This study was a three-group parallel-randomized clinical trial
conducted on 78 patients hospitalized in the cardiac intensive care unit of
Farshchian Heart Hospital in Hamadan during 2024-2025. Patients were
allocated using permuted block sampling method into three groups of 26
patients each: P6 pressure band group, sham group (band without pressure),
and control group (routine care). Time of headache onset, headache severity
(NRS scale), and vital signs including mean arterial pressure, heart rate, and
oxygen saturation were measured at 0, 15, 30, 60, and 120 minutes after
starting the infusion. Data analyzed using Kruskal-Wallis test, one-way ANOVA,
Tukey's post hoc test, repeated measures ANOVA, and Friedman test.
Results: The mean time of headache onset in the pressure band group (101.92
minutes) was significantly longer than the sham group (73.27 minutes) and
control group (54.96 minutes) (P<0.001). The mean headache severity in the
pressure band group (0.62) was significantly lower than the sham group (2.15)
and control group (3.69) (P<0.001). Mean arterial pressure at 15 and 30
minutes showed significant differences among the three groups (P=0.026 and
P=0.001, respectively). Heart rate showed no significant difference among the
groups. Oxygen saturation showed significant changes only in the pressure
band group (P=0.039).
Conclusion: P6 point pressure band is an effective, safe, non-invasive, and
cost-effective method for delaying the onset and reducing the severity of
nitroglycerin infusion-induced headache in patients hospitalized in cardiac
intensive care units. This method integrated into care protocols as an evidence-
based nursing intervention
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