Effect of intra-arterial vasodilator administration during radial artery access on systemic blood pressure in patients receiving moderate sedation. Issue 5 (September 2022)

• Record Type: Journal Article
• Authors: Foster, Haley S; Tabori, Nora E; Sabri, Saher S; Horton, Keith M; Khan, Arshad A; Sivananthan, Gajan
• Is Part Of: Journal of vascular access. Volume 23:Issue 5(2022)
• Page Start: 725
• Page End: 729
• Publication Date: 2022-09
• Subjects: Radial artery spasm -- transradial access -- moderate sedation -- intra-arterial vasodilators; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/11297298211008099
• Languages: English
• ISSNs: 1129-7298

Abstract

Purpose: The hemodynamic effects of intra-arterial vasodilator administration for the prevention of radial artery spasm during transradial access have not been well characterized. This study evaluates the effect of intra-arterial Verapamil and Nitroglycerine administration on systemic blood pressure and its correlation with timing of moderate sedation administration. Materials and methods: Institutional review board approval was granted. Patients who underwent transradial access from 4/2018 to 4/2019 and received both intra-arterial vasodilators and moderate sedation were identified and their electronic medical records reviewed. Patients were divided into three cohorts based on the timing of sedation and intra-arterial vasodilator administration. Decrease in systolic blood pressure (SBP) was expressed as means with standard deviation which were then compared using Student's t -test. Results: A total of 84 patients who met inclusion criteria demonstrated an overall mean decrease in SBP of 16.45 mmHg ± 15.45 mmHg. Patients receiving sedation and intra-arterial vasodilators within their expected peak SBP effect times had similar SBP change following the intra-arterial vasodilators as those in whom the interval was greater than 10 min (4.2 mmHg; 95% CI (−4.11 to 12.52), p = 0.3171). Two patients experienced asymptomatic hypotension. Conclusions: Patients undergoing transradial access for procedures utilizing moderate sedation can safely receive intra-arterial Verapamil and Nitroglycerine for prevention of radial artery spasm.