Candemir Basar, Kumbasar Deniz, Turhan Sibel, Kilickap Mustafa, Ozdol Cagdas, Akyurek Omer, Atmaca Yusuf, Altin Timucin
Department of Cardiology, Ankara University School of Medicine, Ibni Sina Hospital, Ankara 06460, Turkey.
J Vasc Interv Radiol. 2009 Sep;20(9):1151-6. doi: 10.1016/j.jvir.2009.05.034. Epub 2009 Jul 29.
To determine whether subcutaneous administration of nitroglycerin mixed with local anesthetic agent results in effective vasodilation of the radial artery, and whether this technique improves access time and decreases complications.
This prospective study consisted of two consecutive investigations. In the first (n = 30), only local anesthetic agent (prilocaine 2%) was injected into one arm, and local anesthetic agent plus 500 microg nitroglycerin was injected into the other arm. Radial artery diameters before and after injections were measured by ultrasonography. In the second, 33 patients received local anesthetic agent (prilocaine 2%) plus 500 microg nitroglycerin (group A) and 30 received only local anesthetic agent (group B) to determine whether the addition of nitroglycerin would improve radial artery access time, duration of angiography, perception of arterial pulse (ie, pulse score), number of punctures before successful cannulation, and complication rates.
In the first investigation, radial artery diameter increased significantly in the nitroglycerin-treated arm (2.3 mm +/- 0.4 vs 2.9 mm +/- 0.5; P = .05). In the second, there were no significant differences between groups with respect to age, sex, duration of angiography, and number of punctures before cannulation. However, the pulse score increased and radial artery access time improved significantly after addition of nitroglycerin (79% vs 10% [P < .001] and 75 sec +/- 47 vs 132 sec +/- 100 [P = .005], respectively). Radial artery spasm and thrombosis were less frequently observed in group A, albeit to an insignificant extent (P = .39 and P = .49, respectively).
Subcutaneous administration of nitroglycerin significantly increased radial artery diameter, which can lead to facilitation of catheterization of the radial artery for arteriography and interventions.
确定皮下注射与局部麻醉剂混合的硝酸甘油是否能有效扩张桡动脉，以及该技术是否能缩短穿刺时间并减少并发症。
这项前瞻性研究包括两项连续的调查。在第一项研究（n = 30）中，仅将局部麻醉剂（2%丙胺卡因）注入一侧手臂，而将局部麻醉剂加500微克硝酸甘油注入另一侧手臂。注射前后通过超声测量桡动脉直径。在第二项研究中，33例患者接受局部麻醉剂（2%丙胺卡因）加500微克硝酸甘油（A组），30例患者仅接受局部麻醉剂（B组），以确定添加硝酸甘油是否能改善桡动脉穿刺时间、血管造影持续时间、动脉搏动感知（即脉搏评分）、成功插管前的穿刺次数以及并发症发生率。
在第一项调查中，硝酸甘油治疗组的桡动脉直径显著增加（2.3毫米±0.4对2.9毫米±0.5；P = .05）。在第二项研究中，两组在年龄、性别、血管造影持续时间和插管前穿刺次数方面无显著差异。然而，添加硝酸甘油后脉搏评分增加，桡动脉穿刺时间显著改善（分别为79%对10%[P < .001]和75秒±47对132秒±100[P = .005]）。A组桡动脉痉挛和血栓形成的发生率较低，尽管程度不显著（分别为P = .39和P = .49）。
皮下注射硝酸甘油可显著增加桡动脉直径，这有助于在动脉造影和介入操作时对桡动脉进行插管。
