Burning, Pain, Vasospasm;Peripheral
Conditions
Keywords
cardiac catheterization, intra-arterial calcium channel blockers, radial artery spasm
Brief summary
This study will be a randomized, single-blind, prospective trial designed to evaluate the efficacy and safety of intra-arterial (IA) Verapamil diluted with normal saline compared to undiluted IA Nicardipine during transradial access (TRA) for percutaneous coronary angiography. Patients who are 18 years or older and undergoing non-emergent percutaneous coronary angiography via TRA will be included. Patients who are non-English speaking, pregnant, or intubated will be excluded. Patients will be randomized to one of the two following groups: 1. Group 1 will receive IA Verapamil 5 mg (2mL) diluted with 8 mL of normal saline 2. Group 2 will receive IA Nicardipine 400 mcg (undiluted, 8 mL) The investigators will document the patient's level of discomfort on the Visual Analogue Scale 30 seconds before and after administration of IA Verapamil/Nicardipine. The investigators will also document the presence of radial artery spasms.
Interventions
DRUGVerapamil
All patients routinely receive intra-arterial calcium channel blockers during transradial access for coronary angiography.
DRUGNicardipine
Calcium channel blocker
Sponsors
University of Illinois at Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* English Speaking patients who are age 18 or older * Patient must be able to provide own consent and communicate with staff * Patient's undergoing transradial access (TRA) for the left heart catheterization (LHC)
Exclusion criteria
* Intubated or sedated patients * Agitated patients requiring moderate sedation prior to TRA * Patient's undergoing femoral access for the LHC * Non-English speaking patients * Contraindications to Verapamil or Nicardipine: including allergies to these medications, hypotension (mean arterial pressure \<65), Bradycardia (heart rate\<40) * Emergent cardiac catheterization * Inability to obtain radial artery access * Conversion to radial artery access from another access site
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radial Artery Spasm | approximately 30 minutes | The investigators will document the presence or absence of radial artery spasms with either 0,1, or 2. 0 will indicate no radial artery spasms. 1 will indicate radial artery spasms that did not require a change in strategy. 2 will indicate radial artery spasms that required a change in strategy such as alternate access. |
| Pain Prior to Intra-arterial Calcium Channel Blocker Administration | 30 seconds prior to administration | Pain prior to intra-arterial calcium channel blocker administration will be assessed through the Visual Analogue Pain scale (from 0 to 10). |
| Pain After Intra-arterial Calcium Channel Blocker Administration | 30 seconds post administration | Pain after intra-arterial calcium channel blocker administration will be assessed through the Visual analogue Pain Scale (from 0 to 10). |
Countries
United States
Outcome results
None listed