Nitroglycerin Ointment as Aid to Venepuncture

Lohmann, Michael; Möller, Peter; Brynitz, S; Bjerrum, OleW.

doi:10.1016/s0140-6736(84)91918-4

Cited by 14 publications

(10 citation statements)

References 8 publications

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“…Moreover, only one study attempted to assess venous diameter changes objectively using a slide gauge 15 min after application of ointment. In this trial, vasodilator responses were found in only 34% of the patients [4] suggesting that either non-responders were frequent, the dose was too small or that the duration of treatment and/or e ect was too short. Since nitroglycerine is a rather e cient vasodilator, it is also conceivable that some patients were relaxed, venous tone therefore minimal and its pharmacological reversal thus not evident.…”

Section: Discussionmentioning

confidence: 72%

“…Before and after administration of placebo heart rate was 53. 4 Fig. 1) with a maximum of 39.1 21.7% (range 13±72%).…”

Section: Resultsmentioning

confidence: 93%

“…The dilator e ect of ISDN was signi®cantly di erent from the e ect of placebo ointment (analysis of variance, P=0.05). As a control, infusion of nitroglycerine (GTN) into the preconstricted hand vein markedly relaxed the veins in both groups Thus far, nitroglycerine is the only organic nitrate studied in this regard and its e ects have been evaluated 15 [4], 20 [6,10], 60 [7,8,9] and 120 min [5] after local application of ointments or tape. Whenever and however measured, the e ects were highly variable and the optimum time for nitroglycerine application before venepuncture has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…Nitroglycerine e ciently reverses a-adrenergic venoconstriction [2,3] by activation of the nitric oxide±cyclic guanosine monophosphate (NO-cGMP) cascade, a pathway which opposes a-adrenergic e ects under physiological conditions. However, non-responders were frequent [4], the optimum timing with respect to nitrate application has not been established [4,5,6,7,8,9,10] and the extent of venodilation has not been thoroughly investigated. The aim of this study was therefore to quantify venous relaxation over time using a double-blind, placebo-controlled design.…”

Section: Introductionmentioning

confidence: 99%

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Local effect of transdermal isosorbide dinitrate ointment on hand vein diameter

Khanlari

Linder

Haefeli

2001

Eur J Clin Pharmacol

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Objective: To assess the e ect of topically applied isosorbide dinitrate (ISDN) ointment on super®cial hand veins preconstricted with phenylephrine. Methods: Using the hand vein compliance technique, venous diameter changes were measured in a doubleblind, randomised, placebo-controlled cross-over trial in 12 healthy volunteers. During preconstriction with phenylephrine, placebo or ISDN ointment was administered to assess the dilator e ect of transdermal ISDN. Finally a single i.v. dose of nitroglycerine was administered into the hand vein to assess the maximal venous response to organic nitrovasodilators. Results: ISDN ointment (equivalent to 13.4 3.61 mg ISDN) caused a signi®cant dilator e ect of 39.1 21.7% (mean SEM, P=0.02) which reached its maximum after 42.5 16.6 min. Maximum ISDN e ects were inversely correlated with venous baseline diameter (r 2 =0.38, P=0.03) and independent of the amount of ointment applied or the extent of preconstriction (P>0.3). Conclusion: Similar to nitroglycerine, topical ISDN may relax super®cial hand veins within 60 min after application, suggesting that it might ease venepuncture particularly of small vessels. The large variability of the e ect and the time to reach the e ect, however, restrict its practical usefulness.

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Section: Discussionmentioning

confidence: 72%

“…Before and after administration of placebo heart rate was 53. 4 Fig. 1) with a maximum of 39.1 21.7% (range 13±72%).…”

Section: Resultsmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Local effect of transdermal isosorbide dinitrate ointment on hand vein diameter

Khanlari

Linder

Haefeli

2001

Eur J Clin Pharmacol

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“…Ven çapı, vazospazm ve kan akımı ağrılı enjeksiyonun belirleyicilerinden olabilir. Bu konuda da nitrogliserin ile yapılan çalış-malara rastlanmaktadır (23) .…”

Section: Discussionunclassified

Effect of the site of intravascular cannula on injection pain of propofol

Şahinkaya¹,

Akpınar²,

Tekgül³

et al. 2016

Terh

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ÖZAmaç: Propofol hızlı bilinç kaybı ve çabuk derlenme özellikleri nedeniyle genel anestezi indüksiyonunda sıklıkla tercih edilen bir intravenöz sedatif ve hipnotik ajandır. Ancak intravenöz enjeksiyon sırasında yanıcı ağrıya neden olmaktadır. Propofol enjeksiyon ağrısı insidansının %28 ile %90 arasında değiştiği rapor edilmiştir. Bu çalışma ile genel anestezi indüksiyonunda kullanılan propofolün farklı damar yollarından verilmesinin hastada oluşturacağı ağrı ve hasta konforu üzerine etkisinin gözlemlenmesi amaçlanmıştır. Yöntem: Çalışmaya 107 hasta dâhil edildi. Grup 1 (56 hasta)'deki hastalara küçük çaplı venden (el sırtı) ve Grup 2 (51 hasta)'deki hastalara geniş çaplı venden (antekubital) propofol enjekte edildi. Enjeksiyon ağrısı 4 noktalı sözel ağrı derecelendirme skalası ve Wong-Baker yüz skalası ile ölçüldü. Bulgular: Grup 2'de ağrı skorlarında ve ağrı insidansında istatistiksel olarak anlamlı bir azalma görüldü (p<0.001). Sonuç: Sonuç olarak, propofolün büyük çaplı bir vene yerleştirilen intravasküler kanülden uygulanması enjeksiyon ağrısını azaltmada etkilidir. Böylelikle hastalara farmakolojik bir ajan verilmesine gerek kalmamaktadır. Anahtar kelimeler: Antekubital bölge, enjeksiyon ağrısı, propofol ABSTRACTObjective: Propofol is a sedative and hypnothic agent that is mostly used during induction of general anesthesia due to its rapid loss of consciousness and recovery. However it causes pain during intravenous injection. It's reported that incidence of injection site pain of propofol ranges from 28% to 90%. However during intravenous injection it causes burning pain. Methods: 107 patients were included in the study. Propofol was given through a small vein (dorsum of hand) in Group 1 (n=56) patients and through a large vein (antecubital) in Group 2 (n=51) patients. Injection pain was measured using 4 point verbal rating scale and Wong-Baker face scale. Results: It is found that there is a statistically significant decrease in pain scores and incidence in Group 2 (p<0.001). Conclusion: As a result, injection of propofol through an intravascular cannula placed in a large vein is effective for reducing injection site pain. So that, patients have no need for another medication.

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