[Contrast media and pain in peripheral arteriography. Randomized, intra-individual double-blind trial: ioglicinate, ioglicinate-lidocaine, ioxaglate].

The intravasal application of contrast media (CM) can induce pain and heat. We assessed these local side effects by an intraindividual comparison in 60 patients with occlusive arterial disease. A dolorimeter and calorimeter (graduated scales) were employed to register and differentiate the subjective sensations experienced by the patient, while objective reactions (peripheral motoric reactions, circulatory parameters) were recorded by the trial list at the same time. Ioxaglate, an ionic dimer, was distinctly superior to Ioglicinate, an ionic CM. However, the differences were less marked in the comparison with a Ioglicinate-Lidocaine-mixture. Emphasis is given to the fact osmolality is the most important parameter in the generation of pain. Potential points at which the intraarterially administered local anaesthetic could attack are discussed. The clinical conclusions include consideration of the cost-effectivity ratios of the tested CM's and a discussion of whether or not modern standards still justify general anaesthesia for peripheral angiography.