COMPARING THE USE OF IDOCAINE WITH NITROGLYCERIN VERSUS LIDOCAINE FOR PATIENTS UNDERGOING CARDIAC CATHETERIZATION FROM A RADIAL ROUTE IN TERMS OF PAIN INTENSITY, PATIENT SATISFACTION, AND SIDE EFFECTS
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Date
2024-04-10
Authors
Qadous, Mohammad
Journal Title
Journal ISSN
Volume Title
Publisher
An-Najah National University
Abstract
Cardiac catheterizations are specific and complex procedures that are performed either as therapeutic or diagnostic approaches in ischemic heart disease and coronary artery disease. Despite their undisputable benefits, they can also be associated with procedural and post-procedural complications including bleeding, hematoma, pain, radial artery spasms, and occlusion.
This study was conducted to investigate and compare the effects of adding nitroglycerin to lidocaine compared to lidocaine for patients undergoing cardiac catheterization from a radial route.
This was a single-center prospective randomized double-blind study that was conducted among patients scheduled for trans-radial cardiac catheterization. The interventional cardiologist and the patient were blinded to the type of anesthesia. The patients were assigned to receive either the intervention (Group A) or the standard treatment (Group B, control). The intervention consisted of subcutaneous 40 mg of lidocaine with 200 µg of nitroglycerin and intra-arterial 200 µg of nitroglycerin. The standard treatment (control) consisted of subcutaneous 40 mg of lidocaine and intra-arterial 200 µg of nitroglycerin. The assignment was made randomly.
A total of 100 patients were selected randomly and distributed into two groups: 50 patients were allocated to Group A and 50 patients were allocated to Group B. The study patients in both groups were not different in demographic, clinical, and procedural variables (P-value > 0.05). In this study, the addition of nitroglycerin caused significantly less paleness and coldness as an indication of causing less ischemia to the hand (P-value < 0.05). Additionally, the patients who received nitroglycerin in addition to lidocaine reported statistically significant higher satisfaction compared to the patients who received lidocaine (P-value < 0.05).
The findings of this study demonstrated that adding nitroglycerin to lidocaine significantly decreased indicators of hand ischemia as indicated by reduced paleness and coldness. Additionally, adding nitroglycerin to lidocaine significantly increased patient satisfaction. There were no statistically significant differences or increases in puncture time and duration of the intervention. The findings reported in this study might be used by interventional cardiologists and other healthcare providers to improve the provision of trans-radial cardiac catheterization care by reducing complications and improving the safety and recovery of patients. Based on the findings of this study, interventional cardiologists are recommended to add nitroglycerin to lidocaine to reduce hand ischemia and improve patient satisfaction.