Regional intracoronary analgesia during percutaneous transluminal coronary angioplasty

Thomas R Aversano, Gary D Walford, Mark Midei, Paul Chew, Sidney O. Gottlieb, Michael N. Drossner, Harlan Weisman, James L Weiss, Jeffrey A Brinker

Research output: Contribution to journalArticle

Abstract

The ischemic pain associated with balloon inflation during coronary angioplasty remains a significant source of procedural discomfort and sets a limit on the duration of percutaneous transluminal intravascular interventions. The present study examined whether intracoronary lidocaine reduced the pain of coronary angioplasty. Sixteen patients undergoing elective coronary angioplasty underwent three 90 sec balloon inflations: the first with administration of no intracoronary agent, and the second and third with administration of one or the other of placebo or an equal volume of lidocaine (10-16 mg). Placebo or lidocaine were randomized in administration sequence and were given just before balloon inflation. During the occlusions, pain was scored on an ordinal scale (0 = no pain; 10 = most severe pain). Lidocaine delayed the onset of pain (23 ± 4 vs. 48 ± 7 sec, P <0.005) and reduced its magnitude (at end-inflation: 7.8 ± 1.3 vs. 3.2 ± 1.3, P <0.01). There were no significant hemodynamic or electrophysiologic effects in this group of patients, although atrioventricular conduction was delayed when lidocaine was administered into the epicardial coronary which had the atrioventricular node artery as a branch. Intracoronary analgesia with lidocaine is safe and effective in a select group of patients with normal ventricular function undergoing elective coronary angioplasty.

Original languageEnglish (US)
Pages (from-to)93-99
Number of pages7
JournalPain
Volume52
Issue number1
DOIs
StatePublished - 1993

Fingerprint

Coronary Balloon Angioplasty
Lidocaine
Analgesia
Economic Inflation
Angioplasty
Pain
Placebos
Atrioventricular Node
Ventricular Function
Arteries
Hemodynamics

Keywords

  • Coronary angioplasty
  • Intracoronary analgesia
  • Ischemic pain
  • Lidocaine

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)
  • Neurology
  • Pharmacology
  • Clinical Psychology

Cite this

Regional intracoronary analgesia during percutaneous transluminal coronary angioplasty. / Aversano, Thomas R; Walford, Gary D; Midei, Mark; Chew, Paul; Gottlieb, Sidney O.; Drossner, Michael N.; Weisman, Harlan; Weiss, James L; Brinker, Jeffrey A.

In: Pain, Vol. 52, No. 1, 1993, p. 93-99.

Research output: Contribution to journalArticle

Aversano, Thomas R ; Walford, Gary D ; Midei, Mark ; Chew, Paul ; Gottlieb, Sidney O. ; Drossner, Michael N. ; Weisman, Harlan ; Weiss, James L ; Brinker, Jeffrey A. / Regional intracoronary analgesia during percutaneous transluminal coronary angioplasty. In: Pain. 1993 ; Vol. 52, No. 1. pp. 93-99.
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