Background:
Coronary angiography through the radial artery is often accompanied by discomfort at the puncture site. While local anesthetic injections are commonly used, alternative methods, such as the application of EMLA patches (containing lidocaine and prilocaine), are less frequently utilized. This study aimed to evaluate the effectiveness of different pain management techniques, including EMLA patch application, local infiltration with lidocaine, and a combination of both, in patients undergoing radial artery coronary angiography.
Methods:
This retrospective study analyzed data from patients who underwent elective coronary angiography via the radial artery. The patients were divided into three groups: one receiving local infiltration, another using EMLA patches, and a third employing a combination of both treatments. The study collected data on pain intensity, adverse effects, and complications during the procedure and up to 24 hours post-procedure, using standardized pain questionnaires.
Results:
Patients in the combined treatment group (Group 3) reported the least pain during and after the procedure, followed by those receiving only the EMLA patch (Group 2). The highest pain levels were reported by the local infiltration group (Group 1). Pain scores in Group 3 were significantly lower than in Group 1 (p < 0.0001) and Group 2 (p = 0.0006). Additionally, the EMLA patch alone led to a significant reduction in pain compared to local infiltration (p < 0.0001). The duration of EMLA patch application, ranging from 100 to 300 minutes, was linked to a significant decrease in pain intensity. Obesity (BMI ≥30 kg/m²) emerged as a significant predictor of heightened pain perception during the procedure (linear regression coefficient B = 0.962; 95% CI: 0.152–1.772; p = 0.0201) and higher cumulative pain scores within 24 hours after the procedure (B = 2.700; 95% CI: 1.018–4.383; p = 0.0018).
Conclusion:
The combination of EMLA patch and local infiltration offers superior pain relief during radial artery coronary angiography compared to either method used alone. This dual approach significantly enhances patient comfort during and post-procedure, suggesting an optimized pain management strategy for this common clinical procedure.
