ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 26 Issue : 1 Year : 2022
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The Anatolian Journal of Cardiology Comparison of pain severity, satisfaction, and complications of proximal and distal forearm anesthesia in patients undergoing trans-palmar coronary angiography [Anatol J Cardiol]
Anatol J Cardiol. 2022; 26(1): 37-42 | DOI: 10.5152/AnatolJCardiol.2021.282

Comparison of pain severity, satisfaction, and complications of proximal and distal forearm anesthesia in patients undergoing trans-palmar coronary angiography

Farshad Roghani- Dehkordi1, Fereshteh Farazandeh2, Mohammad Kermani- Alghoraishi1, Alireza Khosravi3
1Department of Cardiology, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences; Isfahan-Iran
2Department of Cardiology, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences; Isfahan-Iran
3Department of Cardiology, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences; Isfahan-Iran

Objective: Trans-palmar access is a novel, safe, and feasible technique for coronary artery angiography wherein its appropriate anesthetic methods is still concerned. In this study, we aimed to evaluate the pain severity, satisfaction, and possible complications with local ulnar nerve anesthesia through both distal and proximal forearm in patients undergoing trans-palmar coronary angiography.
Methods: This was a randomized clinical trial performed on 60 patients who were candidates for trans-palmar coronary angiography. The patients were randomized into 2 equal groups as proximal and distal approaches (those who received the same dose of subcutaneous lidocaine (2%) in the proximal and distal of forearm, respectively). Pain intensity at different times, duration of anesthesia, patient satisfaction, and occurrence of complications were evaluated.
Results: The mean age of the patients was 59.45±7.09 years, and, of them, 34 (61.8%) were men. Pain severity with the proximal anesthesia approach was significantly higher than that in the distal group at the time of puncture (5.39±0.73 vs. 2.30±0.60, p=0.001). Over time and immediately after the procedure and at discharge, the mean pain severity in the proximal group was significantly less than in the distal group (p<0.050). The proximal group also had a longer duration of anesthesia (67.14±11.58) than the distal group (53.52±8.06) (p=0.001). No differences were observed in terms of patient satisfaction and complications (p>0.050).
Conclusion: Using the proximal ulnar nerve anesthesia approach was associated with a delayed onset and longer anesthesia than the distal method.

Keywords: anesthesia, ulnar nerve, angiography

Farshad Roghani- Dehkordi, Fereshteh Farazandeh, Mohammad Kermani- Alghoraishi, Alireza Khosravi. Comparison of pain severity, satisfaction, and complications of proximal and distal forearm anesthesia in patients undergoing trans-palmar coronary angiography. Anatol J Cardiol. 2022; 26(1): 37-42

Corresponding Author: Mohammad Kermani- Alghoraishi, Iran
Manuscript Language: English