• Ahmed Hasanin, Amel Aboelela, Maha Mostafa, Rehab Mohamed Mansour, and Ahmed Kareem.
• Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
• J. Cardiothorac. Vasc. Anesth. 2020 Dec 1; 34 (12): 3354-3360.

ObjectivesTo determine whether the use of topical nitroglycerin patch increases radial artery diameter and facilitate cannulation in children.DesignRandomized controlled trial.SettingCairo University Hospital.ParticipantsChildren aged 2 to 8 years old scheduled for cardiac surgery.InterventionIn the nitroglycerin group (n = 20), a gauze-covered, half-sized nitroglycerin patch (5 mg) was applied at the site of radial pulsation 1 hour before induction of anesthesia. In the control group (n = 20), a gauze pad was applied to the bare skin at the site of radial pulsation with no intervention.Measurements And Main ResultsThe primary outcome was the diameter of the radial artery in both limbs using ultrasonography. Other outcomes included the degree of arterial palpability, number of arterial punctures, and incidence of successful first puncture cannulation. The radial artery diameter increased after 30 minutes and 60 minutes compared with the baseline value in the nitroglycerin group in both limbs, whereas no change was reported in the radial artery diameter in the control group. The nitroglycerin group showed a greater incidence of successful first cannulation trial, a fewer number of trials, and a shorter cannulation time compared with the control group. There were no significant hypotensive episodes in any patient.ConclusionLocal application of a half-sized, 5 mg nitroglycerin patch for 60 minutes in children increased the radial artery diameter bilaterally, increased the rate of first trial success, and decreased the time needed for arterial cannulation without significant hypotensive episodes.Copyright © 2020 Elsevier Inc. All rights reserved.

12 keywords...

hide…