|
|
|
| Clinical Observation on the application of mixed Solution with Lidocaine and Nitroglycerin in Radial Artery Puncture |
| WANG Kun, CHANG Xin, et al |
| General Hospital of Beijing Military Region, Beijing 100700, China |
|
|
|
|
Abstract Objective: To explore the efficacy and safety of subcutaneous injection of lidocaine-nitroglycerin mixed solution to relieve radial artery spasm and improve the success rate of puncture. Method: A total of 214 patients with radial artery spasm during the course of puncture, from May 2013 to May 2015 in the cardiology of Beijing Military General Hospital, were randomly divided into experimental group and control group. The patients in the experimental group were given 1% lidocaine 1.5ml + nitroglycerin injection 0.5ml (2.5mg) mixed solution subcutaneous injection, and the patients in the control group were given 1% lidocaine injection 2ml subcutaneous injection. Record the changes of radial artery pulsation、blood pressure and heart rate before and after treatment. Results: There was no significant difference in age, sex, hypertension, myocardial infarction,diabetes mellitus,smoking,LVEF,serum creatinine and high sensitivity C-reactive protein between the two groups (P<0.05). The time of puncture was 5.21 ±1.119 min in the experimental group and 8.32±1.506 min in the control group. The puncture time of the experimental group was significantly lower than that of the control group (P = 0.000). The number of puncture was 4.33±1.014 in the experimental group and 6.29±1.324 in the control group. The difference was statistically significant (P = 0.000). The time of recovery pulsation of radial artery was 1.79±0.399 min in the experimental group and 3.36±0.629 min in the control group. The time of recovery pulsation of radial artery in the experimental group was significantly shorter than that in the control group. The difference was statistically significant (P = 0.000). (5) The success rate of puncture was 94.44% in the experimental group and 81.13% in the control group. The difference was statistically significant (P = 0.003). Before and after treatment, there were no significant change in blood pressure, headache, new arrhythmia and other adverse reactions of the two groups. Conclusion: The subcutaneous injection of 1% lidocaine 1.5ml+ 0.5ml nitroglycerin (2.5mg) mixed solution can effectively improve the radial artery spasm, improve the success rate of puncture, reduce the number of puncture, and shorten the time of puncture, with no obvious adverse reaction. Which is safe and effective, worthy of recommendation to use.
|
|
|
|
|
|
[1] Campeau L. Percutaneous radial approach for coronary angiography[J].Cathet Cardiovasc Diagn,1989; 16( 1) : 3~5.
[2] Fukuda N,Iwahara S,Harada A, et al. Vasospasms of the radial artery after the transradial approach for coronary angiography and angioplasty[J].Jpn Heart ,2004; 45( 5) : 723~731.
[3] Hildick-Smith D J,Walsh J T,Lowe M D,et al.Transradial coronary angiography in patients with contraindications to the femoral approach:an analysis of 500 cases[J].Catheter Cardiovasc Interv, 2004,(61):60~66.
[4] Jolly SS, Amlani S, Hamon M, et al. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials[J].Am Heart J, 2009, 15(7): 132~140.
[5] Vorobcsuk A, Kónyi A, Aradi D, et al. Transradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction Systematic overview and meta-analysis[J].Am Heart, 2009,
[6] Ruiz-Salmeron RJ,Mora R,Velez-Gimon M,et al. Radial artery spasm in transradial cardiac catheterization. Assessment of factors related to its occurrence, and of its consequences during follow-up[J].Rev Esp Cardiol,2005,58(5):504~511.
[7] Goldberg S L,Renslo R,Sinow R,et al.Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty[J].Cathet Cardiovasc Diagn ,1998, 44( 2):147~152.
[8] Shapira O M,Xu A,Aldea G S,et al.Enhanced nitricoxide-medi-ated vascular relaxation in radial artery compared with internal mam-mary artery or saphenous vein[J].Circulation,1999,100( s19):322~327.
[9] 沈刘忠,陈绪军,陈鑫.老年冠状动脉粥样硬化性心脏病患者桡动脉抗痉挛药物选择的实验研究[J].中华外科杂志;2010,48(19):1488~1491
[10] Shapira O M,Xu A,Aldea G S,et al.Enhanced nitricoxide-medi-ated vascular relaxation in radial artery compared with internal mam-mary artery or saphenous vein[J].Circulation,1999,100( s19):322~327.
[11] 杨宝峰,苏定冯,周宏灏.药理学[M].第7版.北京:人民卫生出版社,2010.124~125. |
|
|
|
2017, Vol. 23 
