Intraarterial analgesia in peripheral arteriography

Guthaner, DF; Silverman, J M; Wg, Hayden; Wexler, L

doi:10.2214/ajr.128.5.737

Cited by 15 publications

(5 citation statements)

References 8 publications

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“…Intra-arterial lidocaine administration during TACE has been known not only for reduction of severity of the pain that is associated with TACE but facilitates faster recovery as well 11,12 . Lidocaine has been shown to help control the painful response to the injection of iodinated contrast material in peripheral arteries 16,17 . Molgaard et al 11 studied the use of intra-arterial lidocaine in hepatic arterial branches prior to and during TACE.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intra-Arterial Lidocaine for Pain Control Resulting From Transarterial Chemoembolization of Hepatocellular Carcinoma

Abbas

Sheraz

Rahim

2021

PAFMJ

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Objective: To assess the efficacy of intra-arterial lidocaine in peri & post-procedural pain control and the dose of narcotic analgesic required in hepatocellular carcinoma patients undergoing transarterial chemoembolization. Study Design: Comparative prospective study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging Rawalpindi, from Jan to Jun 2019. Methodology: A total of 60 patients included in this study where 42 males and 18 were females, age range 45-85 years who underwent transarterial chemoembolization for hepatocellular carcinoma, were included in the study. patients were equally divided into two groups, group a (30 patients) who underwent transarterial chemoembolization, received 60 mg of intraarterial lidocaine each and group b (30 patients) who underwent transarterial chemoembolization, intra-arterial lidocaine was substituted with normal saline.degree of post-procedural pain was assessed using a subjective method (visual analogue scales score) and an objective method (amount of post-procedural analgesics). Results: Average peri-procedure visual analogue scale score was 5.06 in group A patient versus 7.2 for those in group B patients (p=0.037). Post-procedure visual analogue scale score in the group A was 2.7 ± 0.520 and that for group B was 4.2 ± 0.761 (p=0.025). Mean of total dose of nalbuphine in group A was 4.96 ± 0.764 mg versus 8.3 ± 1.34 mg for patients in group B (p=0.036). Average length of post procedure hospital stay was 0.9 ± 0.203 and 1.41 ± 0.373 days for group A and group B respectively (p=0.002).Conclusion: Intra-arterial administration of lidocaine before infusing the embolization particles for transarterial chemoembolization.....................

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Section: Discussionmentioning

confidence: 99%

Efficacy of Intra-Arterial Lidocaine for Pain Control Resulting From Transarterial Chemoembolization of Hepatocellular Carcinoma

Abbas

Sheraz

Rahim

2021

PAFMJ

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“…A decrease in osmolality within this range will occur if a ratio 1.5 contrast medium with an osmolality of 1.5-2.0 mol/kg is diluted by adding 10 volume per cent of an anesthetic solution almost isotonic to blood. Therefore the results of several of the reviewed investigations (15,16,21,28,30,38) may be influenced by an unfair comparison between an undiluted and a diluted contrast medium.…”

Section: Discussionmentioning

confidence: 99%

Addition of Local Anesthetics to Contrast Media

Nilsson¹,

Almén²,

Golman³

et al. 1987

Acta Radiol

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Effects of equiosmolar solutions (osmolality 1.35 mol/kg) of the ratio 1.5 contrast medium metrizoate (250 mg l/ml) containing either the local anesthetic mepivacaine or saline were evaluated on subjective discomfort, aortic blood pressure and heart rate in 17patients referred for aortofemoral angiography due to intermittent claudication. Each patient was injected with 30 ml (15 mils) of each solution in random double-blind order. Each patient was then injected with 45 ml (12 ml/s) of the ratio 3 medium ioxaglate (320mg l/ml, osmolality 0.58 mIlkg). loxaglate caused significantly less total discomfort, pain, heat, vocal reactions, involuntary movements and hemodynamic effects than metrizoate-mepivacaine and metrizoate-saline. The effects of the two metrizoate solutions did not differ significantly. Previous contradictory reports on the effects of anesthetics in contrast media were reviewed with regard to experimental design, different osmolality of the test and control solutions, premedication, and pH dependence of local anesthetics. Ratio 3 media are recommended because they produce a more reliable relief of patient discomfort and fewer hemodynamic changes than the addition of loc'al anesthetics to ratio 1.5 media.

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“…The findings are contradictory while some investigators claim that the addition of local anesthetics gives good relief of contrast medium pain (9)(10)(11)26), others find no such effect (6,17,26).…”

mentioning

confidence: 94%

Addition of Local Anesthetics to Contrast Media

Nilsson¹,

Almén²,

Golman³

et al. 1988

Acta Radiol

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The acute intravenous toxicity (i.v. LD 50 ) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition oflocal anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions.

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Intraarterial analgesia in peripheral arteriography

Cited by 15 publications

References 8 publications

Efficacy of Intra-Arterial Lidocaine for Pain Control Resulting From Transarterial Chemoembolization of Hepatocellular Carcinoma

Efficacy of Intra-Arterial Lidocaine for Pain Control Resulting From Transarterial Chemoembolization of Hepatocellular Carcinoma

Addition of Local Anesthetics to Contrast Media

Addition of Local Anesthetics to Contrast Media

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