Keshav Patel, Melissa Duckett, Mladen I Vidovich, Khalil Ibrahim
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Patient discomfort and/or pain was assessed using the Visual Analogue Scale (VAS) both before and after IA administration of nicardipine or verapamil.</p><p><strong>Results: </strong>There was a statistically significant difference in mean change in VAS scores between the 2 groups, with an average increase in VAS score of 0.88 in the nicardipine group and 4.81 in the verapamil group (p < 0.0001). The overall rate of RAS was low in our study (5.5 %) with no significant difference in RAS incidence between the 2 groups (p = 0.465). The nicardipine group had 2 RAS cases (7.7 %), with 1 requiring a change in strategy (3.8 %). The verapamil group had 1 RAS case (3.4 %) that did not require a change in strategy.</p><p><strong>Conclusion: </strong>In this trial, we showed that nicardipine causes significantly less discomfort and pain compared to verapamil during IA administration for TRA cardiac catheterization.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intra-arterial nicardipine versus verapamil during transradial access coronary catheterization.\",\"authors\":\"Keshav Patel, Melissa Duckett, Mladen I Vidovich, Khalil Ibrahim\",\"doi\":\"10.1016/j.carrev.2024.08.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Intra-arterial (IA) vasodilators are recommended during transradial access (TRA) to prevent radial artery spasm (RAS). 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引用次数: 0
摘要
导言:建议在经桡动脉入路(TRA)时使用动脉内(IA)血管扩张剂,以防止桡动脉痉挛(RAS)。美国心脏协会(AHA)建议使用维拉帕米、地尔硫卓、尼卡地平或硝酸甘油来预防 RAS。据我们所知,维拉帕米和尼卡地平对 RAS 的预防效果和患者耐受性还没有进行过直接的随机比较:我们进行了一项前瞻性、单盲随机临床试验,比较了接受 400 μg 体内注射尼卡地平(26 人)或 5 mg 体内注射维拉帕米(29 人)的患者的不适感。在服用尼卡地平或维拉帕米前后,均使用视觉模拟量表(VAS)对患者的不适和/或疼痛进行评估:结果:两组 VAS 评分的平均变化差异有统计学意义,尼卡地平组 VAS 评分平均增加 0.88 分,维拉帕米组则平均增加 4.81 分(p 结论:尼卡地平和维拉帕米的疗效均优于尼卡地平:本试验表明,与维拉帕米相比,尼卡地平在 TRA 心导管植入术中引起的不适和疼痛明显更少。
Intra-arterial nicardipine versus verapamil during transradial access coronary catheterization.
Introduction: Intra-arterial (IA) vasodilators are recommended during transradial access (TRA) to prevent radial artery spasm (RAS). The American Heart Association (AHA) recommends either IA verapamil, diltiazem, nicardipine, or nitroglycerin to prevent RAS. To our knowledge, the efficacy of RAS prevention and patient tolerability of verapamil and nicardipine has not been directly compared in a randomized fashion.
Methods: We conducted a prospective, single-blinded randomized clinical trial comparing the discomfort experienced by patients receiving either 400 μg of IA nicardipine (n = 26) or 5 mg of IA verapamil (n = 29). Patient discomfort and/or pain was assessed using the Visual Analogue Scale (VAS) both before and after IA administration of nicardipine or verapamil.
Results: There was a statistically significant difference in mean change in VAS scores between the 2 groups, with an average increase in VAS score of 0.88 in the nicardipine group and 4.81 in the verapamil group (p < 0.0001). The overall rate of RAS was low in our study (5.5 %) with no significant difference in RAS incidence between the 2 groups (p = 0.465). The nicardipine group had 2 RAS cases (7.7 %), with 1 requiring a change in strategy (3.8 %). The verapamil group had 1 RAS case (3.4 %) that did not require a change in strategy.
Conclusion: In this trial, we showed that nicardipine causes significantly less discomfort and pain compared to verapamil during IA administration for TRA cardiac catheterization.
期刊介绍:
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.