Analgesic Effect Of Hot Compress With Lidocaine Compound Cream In Percutaneous Coronary Intervention With Transradial Approach

Objective: To investigate whether the local anesthesia with lidocaine injection couldbe replaced by the hot compress of lidocaine compound cream before the radial arterypuncture in PCI, with respect to relieving pain of local anesthesia, improving puncturesuccess rate, reducing puncture time, lowering the possibility of intervention approachchange, and decreasing incidence of post-PCI complications.Methods: We designed a single-blind, randomized, controlled trial described asfollowing. For the experiment group, instead of local anesthesia, the radial artery puncturepoint was applied lidocaine compound cream and consequent hot compress with salinemoistened warm gauze (40℃), in addition with continuous infrared hot compressinstrument for60minutes. In control group, the coupling agent for ultrasonography wasused as placebo instead of lidocaine cream, and the local anesthesia using lidocaineinjection was routinely employed. The following indices were compared in between thetwo groups:1. pain score at puncture, procedure ending, and3hours after operation,2.success rate of puncture, puncture time, and incidences of intervention approach changingto humeral or femoral artery,3. incidence and severity of puncture-related complications,such as post-operative peusoaneurysm, artery-vein fistula, subcutaneous hemorrhage,hematoma, extremity swelling of the same side.Results: Pain scores of experiment group at puncture (P<0.001), procedure ending,and3hours after operation (P<0.01) were significantly lower than control. The puncturetime was much shorter than control (P<0.001). There were no statistical differenceregarding to complication incidences, such as extremity swelling, hematoma, andsubcutaneous hemorrhage (P>0.05), and rate of approach changing (P>0.05). The successrate of puncture was100%in both groups. Conclusion: The traditional local anesthesia with lidocaine injection can be replacedby the hot compress of lidocaine compound cream in PCI with radial artery approach, dueto stable and long-lasting analgesia effect, simple procedure, and shortened puncture time.