Effects of Adding Papaverine for the Local Anesthesia of the Access Site in the Transradial Approach for Cardiac Catheterization

Abstract

Background: Transradial coronary arteriography has been developed as the first method of choice for interventional procedures in many centers, and its feasibility and safety contribute to its popularity. Gaining access is the main step in radial artery arteriography. We sought to evaluate the efficacy of the preprocedural administration of papaverine in diminishing arteriography complications. Methods: A total of 120 patients were enrolled in the present study. The study population was divided into 2 equal groups of 60 patients. One group was catheterized with the preprocedural administration of papaverine, and the other group was administered traditional TNG. The groups were thereafter compared in terms of the administration of papaverine versus traditional TNG. Results: No significant difference was observed between the 2 groups concerning failure to gain radial access. There was a significant difference in the time to gain access (P=0.016) and in the number of tries to gain access (P=0.007) between the study groups, and both of these values were lower in the papaverine group. Subgroup analysis revealed that the time to gain access was significantly lower in the male patients (P=0.035), younger patients (P=0.008), and smokers (P=0.043). There was also a significant difference in favor of the papaverine administration with respect to the operator's experience in the low-volume operators. Additionally, a shorter procedure time was observed in the papaverine group, which was more meaningful in the nondiabetic and nonhypertensive cases. Conclusions: The preprocedural administration of papaverine in radial artery angiography confers benefits and could, thus, be a suitable substitution for traditional TNG with a view to diminishing the undesirable consequences of radial artery catheterization.