title: Double-blind, randomized, placebo-controlled evaluation of atropine to prevent vasovagal reaction during removal of femoral arterial sheaths.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of atropine in preventing vasovagal reactions (VVRs) during removal of femoral arterial sheaths after diagnostic left heart catheterization.
  
  
  METHODS
  Prospective, double-blind, randomized, placebo-controlled study.
  
  
  METHODS
  University-affiliated, 450-bed teaching hospital.
  
  
  METHODS
  One hundred sixty-five patients undergoing left heart catheterization.
  
  
  METHODS
  Eighty-eight patients were assigned to receive atropine 0.5 mg intravenously and 77 received placebo 5 minutes before sheath removal.
  
  
  RESULTS
  The frequency of VVRs was significantly reduced in the atropine group compared with the placebo group, 2.3% and 10.4%, respectively (overall relative risk in the atropine group 0.22, 95% CI 0.12-0.41, p=0.03). Significant decreases in systolic (35.2 +/- 5.8 mm Hg, p<0.001) and diastolic blood pressures (12.6 +/- 12.6 mm Hg, p=0.002) occurred in the 10 patients with VVRs compared with those without VVR. No cardiac arrhythmias occurred after atropine administration. Dry mouth was the only side effect reported with atropine (8/88, 9%).
  
  
  CONCLUSIONS
  Atropine significantly reduced the frequency of VVRs associated with removal of femoral arterial sheaths after diagnostic left heart catheterization. The drug should be studied in a larger series of patients to assess its ability to decrease the morbidity and costs associated with VVR.
authors.affiliation: Creighton University Cardiac Center, Omaha, Nebraska 68131, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Rama
authors.forename: S M
authors.initials: SM
authors.lastname: Mohiuddin
authors.forename: A N
authors.initials: AN
authors.lastname: Mooss
authors.forename: A K
authors.initials: AK
authors.lastname: Khemani
authors.forename: K L
authors.initials: KL
authors.lastname: Ryschon
authors.forename: B D
authors.initials: BD
authors.lastname: Lucas
authors.forename: D E
authors.initials: DE
authors.lastname: Hilleman
mesh_terms: D001285:Atropine / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization / Q000009:adverse effects*; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005263:Femoral Artery / Q000294:innervation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D014630:Vagus Nerve / Q000187:drug effects / Q000502:physiology; D014652:Vascular Diseases / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D018727:Muscarinic Antagonists; D001285:Atropine