Effect of intra-arterial vasodilator administration during radial artery access on systemic blood pressure in patients receiving moderate sedation.

Abstract

PURPOSE\nThe 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.\n\n\nMATERIALS AND METHODS\nInstitutional 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.\n\n\nRESULTS\nA total of 84 patients who met inclusion criteria demonstrated an overall mean decrease in SBP of 16.45\u2009mmHg\u2009±\u200915.45\u2009mmHg. 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\u2009min (4.2\u2009mmHg; 95% CI (-4.11 to 12.52), p\u2009=\u20090.3171). Two patients experienced asymptomatic hypotension.\n\n\nCONCLUSIONS\nPatients undergoing transradial access for procedures utilizing moderate sedation can safely receive intra-arterial Verapamil and Nitroglycerine for prevention of radial artery spasm.