Nitroglycerine Ointment as an Aid to Venepuncture

Hecker, James; Lewis, G. B. H.; Stanley, Helen; Smith, Robert M.

doi:10.1097/00132586-198310000-00025

Cited by 6 publications

(8 citation statements)

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“…When GTN is used topically on its own it causes local venodilation which assists in venous cannulation. [5][6][7]14 This study, like previous studies, has shown that when GTN is used in the presence of EMLA, the GTN promotes venous dilation and therefore cannulation is technically easier 8,9 . This is illustrated by less blanching, an increased incidence in larger veins and easy cannulations when EMLA is combined with GTN compared with EMLA on its own.…”

Section: Discussionsupporting

confidence: 67%

“…Previous studies have shown a similar incidence of side-effects. [5][6][7][8][9] This was not unexpected as the dose of GTN used was well below the dose used in the treatment of angina.…”

Section: Discussionmentioning

confidence: 99%

“…The use of glyceryl trinitrate (GTN) ointment has been used to produce local venodilation and increases the ease of venous cannulation [5][6][7] . This has been shown to occur even in the presence of EMLA cream 8,9 .…”

mentioning

confidence: 99%

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The Application of EMLA and Glyceryl Trinitrate Ointment Prior to Venepuncture

Andrew

1996

Anaesth Intensive Care

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The efficacy of EMLA ® cream combined with glyceryl trinitrate (GTN) ointment was assessed by a double-blind prospective study. Adult female patients were randomly allocated to receive either EMLA 1 ml or 2 ml combined with GTN 2 mg, or EMLA 2 ml only. The difference in pain scores between the three groups was not statistically significant. When GTN was used with EMLA, the quality of the veins was superior and aided intravenous cannulation. There were no significant side-effects. It is concluded that if GTN is used with EMLA, the dose of EMLA can be reduced and intravenous cannulation is technically easier compared with EMLA alone.

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Section: Discussionsupporting

confidence: 67%

“…Previous studies have shown a similar incidence of side-effects. [5][6][7][8][9] This was not unexpected as the dose of GTN used was well below the dose used in the treatment of angina.…”

Section: Discussionmentioning

confidence: 99%

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The Application of EMLA and Glyceryl Trinitrate Ointment Prior to Venepuncture

Andrew

1996

Anaesth Intensive Care

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“…While allowing painless cannula insertion, the venoconstrictive effects of EMLA can make the procedure technically more difficult in children who already have small veins. Glyceryl trinitrate (GTN) has been shown to cause local venous dilatation, and facilitate venous cannulation when applied topically in adults [8][9][10] . The use of EMLA and GTN combined has been investigated in adults and found to improve venous size, quality, and aid intravenous cannulation with no statistically significant difference in pain scores [11][12][13][14] .…”

mentioning

confidence: 99%

The Use of Glyceryl Trinitrate Ointment with EMLA Cream for IV Cannulation in Children Undergoing Routine Surgery

Andrew

Barker

Laing

2002

Anaesth Intensive Care

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This prospective randomized controlled double-blind trial was performed to investigate whether glyceryl trinitrate (GTN) ointment, applied ten minutes after the removal of a eutectic mixture of local anaesthetic cream, lignocaine/ prilocaine (EMLA), influences site selection for intravenous cannulation in children. Eighty children aged between five and 15 years, having general surgery as day patients, received EMLA cream on both hands for 90 minutes prior to transfer to the theatre suite. Acting as their own controls, the children received GTN on one hand, and placebo on the other, after removal of the EMLA cream and ten minutes prior to the insertion of an intravenous cannula. The application of GTN or placebo to left or right hand was blinded and randomized. At induction, the hand with the visually best quality veins was selected and cannulated. The primary outcome was selection between the EMLA/GTN hand and EMLA/placebo hand. The selection having been made, the number of attempts at cannulation, ease of insertion and pain scores (VAS) for cannulation were also recorded. The choice of hand was positively influenced by the use of GTN, with the GTN hand chosen in 51 of 72 (70%) children who completed the protocol (P=0.001). The findings of this study suggest that the application of GTN after EMLA removal may be clinically useful in aiding cannulation in children.

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“…The first successful use of GTN ointment as an aid to venipuncture was reported in 1983 in a randomized placebo-controlled trial [8]. Other investigations showed an increasing diameter of the veins [9,10], or better success rate for venipuncture [11].…”

Section: Facilitating Techniques For Peripheral Venipuncturementioning

confidence: 99%

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Haas

2004

Crit Care

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The current literature on venous access in infants and children for acute intravascular access in the routine situation and in emergency or intensive care settings is reviewed. The various techniques for facilitating venous cannulation, such as application of local warmth, transillumination techniques and epidermal nitroglycerine, are described. Preferred sites for central venous access in infants and children are the external and internal jugular veins, the subclavian and axillary veins, and the femoral vein. Femoral venous cannulation appears to be the most safe and reliable technique in children of all ages, with high success and low complication rates. Evidence from the reviewed literature strongly supports the use of real-time ultrasound techniques for venous cannulation in infants and children. Additionally, in emergency situations intraosseous access has almost completely replaced saphenous cutdown procedures in children and has decreased the need for immediate central venous access.

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Nitroglycerine Ointment as an Aid to Venepuncture

Cited by 6 publications

References 0 publications

The Application of EMLA and Glyceryl Trinitrate Ointment Prior to Venepuncture

The Application of EMLA and Glyceryl Trinitrate Ointment Prior to Venepuncture

The Use of Glyceryl Trinitrate Ointment with EMLA Cream for IV Cannulation in Children Undergoing Routine Surgery

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