Reflexology Massage Versus Routine Care Technique on Pain of Sheath Removal After Percutaneous Coronary Intervention: A Randomized Control Trial

Objective: To evaluate and compare the effectiveness of foot reflexology versus routine care in alleviating pain intensity during arterial sheath removal among patients undergoing percutaneous coronary intervention (PCI). Methods: A randomized controlled trial was conducted at three cardiology centres in Iraq from November 2024 to January 2025. A total of 57 post-PCI patients were randomly assigned to intervention and control groups using sealed opaque envelopes. Pain intensity was assessed using the 100 mm Visual Analogue Scale (VAS) immediately after femoral sheath removal (Pain 1) and 20 minutes later (Pain 2). The intervention group received foot reflexology immediately after sheath removal, involving gentle massage of both feet followed by two minutes of targeted pressure on reflex zones. The control group received routine post-sheath removalcare. Demographic and clinical data such as age, BMI, chronic diseases, smoking history, and previous PCI werealso recorded.Results: The median age of the patients was 57 years (51.0-63.5). The overall median pain score immediately after femoral sheath removal was 51.0 (38.5–65.5), which decreased to 41.0 (31.5–53.5) after 20 minutes. There were 31 (54.4%) patients in the control group and 26 (45.6%) patients in the foot reflexology group. Median pain scores were significantly lower in the reflexology group compared to the control group both immediately after sheath removal (39.0 vs. 63.0) (p-value < 0.001) and 20 minutes later (32.0 vs. 52.0) (p-value < 0.001). Conclusion: Foot reflexology is an effective non-pharmacological intervention that significantly reduces pain intensity in patients undergoing arterial sheath removal after PCI.