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 2018. fifty cardiovascular patients prescribed enoxaparin were randomly assigned to a cold compress group (n=25) or a control group (n=25). 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 5-minute application of a standardized ice pack before the second injection. pain intensity was measured immediately and 5 minutes post-injection using the visual analog scale (vas).results: baseline pain scores were similar between the cold compress and control groups (p>0.05). 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=4.4, 95% ci: 3.7 to 5.1) compared to the control group (adjusted m=5.6, 95% ci: 4.9 to 6.3; p=0.01). a similar significant reduction was observed at 5 minutes post-injection (adjusted m=3.9, 95% ci: 3.3 to 4.6 vs. adjusted m=5.3, 95% ci: 4.6 to 5.9; p=0.01).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.