title: Eutectic mixture of local anesthesia cream can reduce both the radial pain and sympathetic response during transradial coronary angiography.
abstract: OBJECTIVE
  ADIAL ARTERY SPASM IS ONE OF THE MOST COMMON COMPLICATIONS OF TRANSRADIAL CORONARY ANGIOGRAPHY (TRA): the radial artery is prone to cathecholamine-induced contraction and radial pain during TRA could increase the sympathetic tone. The object of this study was to evaluate whether the eutectic mixture of local anesthesia (EMLA) cream, in addition to lidocaine infiltration, could reduce the sympathetic response by reducing radial pain during TRA.
  
  
  METHODS
  Seventy-six patients were randomized 1 : 1 to either EMLA or control groups. Radial pain was measured by the visual analogue scale (VAS) and the verbal rating scale (VRS-4). Sympathetic response, including systolic (SBP) and diastolic blood pressure (DBP), pulse rate (PR), stroke volume (SV) and total peripheral resistance (TPR), was measured by photoplethysmography.
  
  
  RESULTS
  RADIAL PAIN MEASURED DURING LIDOCAINE INFILTRATION WAS SIGNIFICANTLY LOWER IN THE EMLA GROUP (VAS: 3.1 vs. 4.0, p=0.04; VRS-4: 2.0 vs. 2.2, p=0.03) and the sympathetic response was significantly blunted in the EMLA group from baseline to lidocaine infiltration (ΔSBP, mm Hg: 5 vs. 13, p<0.01; ΔDBP, mm Hg: 2 vs. 7, p=0.03; ΔPR, beat/min: 2 vs. 8, p<0.01, ΔSV, mL: 3 vs. 21, p<0.01; ΔTPR, mm Hg · L/min: 1.0 vs. 5.9, p<0.01).
  
  
  CONCLUSIONS
  In patients undergoing TRA, the EMLA cream, in addition to lidocaine infiltration, effectively reduces the radial pain and thereby the sympathetic response, during lidocaine infiltration.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Youn
authors.forename: Woo-Taek
authors.initials: WT
authors.lastname: Kim
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Sung-Gyun
authors.initials: SG
authors.lastname: Ahn
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Ahn
authors.forename: Jang-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Byung-Su
authors.initials: BS
authors.lastname: Yoo
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Kyung-Hoon
authors.initials: KH
authors.lastname: Choe