Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty

Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty Publisher

Mikailimirak S¹ ; Talasaz AH^{1, 2} ; Jenab Y² ; Vatanara A³ ; Amini M⁴ ; Jalali A² ; Gheymati A¹

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1. Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
2. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
3. Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
4. Department of Medicinal Chemistry, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Source: IJC Heart and Vasculature Published:2021

Abstract

Introduction: Radial approach for coronary angioplasty is accepted by many specialists in medical centers around the world. The use of radial access is associated with fewer vascular complications and the same success rate in comparison with traditional femoral access. Radial artery spasm is one of the main concerns in this method. The small size of the radial artery and high density of alpha-1 adrenergic receptors in this artery can accelerate the spasm. The objects of this study were to evaluate whether the combined topical gel of lidocaine–verapamil–nitroglycerin could dilate the radial artery and reduce patient pain and sympathetic response during radial puncture. Methods: Patients undergoing elective trans-radial angioplasty were randomized to either placebo or therapeutic gel group in single-center, double-blind study. Placebo or therapeutic gel applied 1 cm proximal to the radial styloid process. Radial artery size was measured by ultrasound. Radial pain was reported by the visual analog scale (VAS) and the sympathetic response was assessed by changes in systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR). The incidence of spasm was defined by the radial artery spasm score. Results: 60 patients (30 patients in each group) participated in this study. A significant increase in the size of the radial artery was observed in the group receiving therapeutic gel compared to the placebo group (mean diameter, mm: 2.95 ± 0.48 vs. 2.54 ± 0.43, p = 0.001; area, cm2: 0.07 vs. 0.05, p = 0.001). During radial puncture, the radial pain intensity was significantly decreased in patients receiving therapeutic gel (4 (1–5) vs. 2 (1–2), p = 0.003). Radial artery spasm didn't happen in any group. Conclusion: Based on our results, Pre-procedural administration of combined topical gel of verapamil-nitroglycerin-lidocaine significantly increases the size of the radial artery and effectively reduces the radial pain during radial puncture in patients undergoing trans-radial angioplasty. © 2020 The Authors

Style	Citing Format
MLA	Mikailimirak S, et al.. "Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty." IJC Heart and Vasculature, vol. 32, no. , 2021, pp. -.
APA	Mikailimirak S, Talasaz AH, Jenab Y, Vatanara A, Amini M, Jalali A, Gheymati A (2021). Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty. IJC Heart and Vasculature, 32(), -.
Chicago	Mikailimirak S, Talasaz AH, Jenab Y, Vatanara A, Amini M, Jalali A, Gheymati A. "Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty." IJC Heart and Vasculature 32, no. (2021): -.
Harvard	Mikailimirak S et al. (2021) 'Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty', IJC Heart and Vasculature, 32(), pp. -.
Vancouver	Mikailimirak S, Talasaz AH, Jenab Y, Vatanara A, Amini M, Jalali A, et al.. Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty. IJC Heart and Vasculature. 2021;32():-.
BibTex	@article{ author = {Mikailimirak S and Talasaz AH and Jenab Y and Vatanara A and Amini M and Jalali A and Gheymati A}, title = {Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty}, journal = {IJC Heart and Vasculature}, volume = {32}, number = {}, pages = {-}, year = {2021} }
RIS	TY - JOUR AU - Mikailimirak S AU - Talasaz AH AU - Jenab Y AU - Vatanara A AU - Amini M AU - Jalali A AU - Gheymati A TI - Novel Combined Topical Gel of Lidocaine–Verapamil–Nitroglycerin Can Dilate the Radial Artery and Reduce Radial Pain During Trans-Radial Angioplasty JO - IJC Heart and Vasculature VL - 32 IS - SP - EP - PY - 2021 ER -

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