Background: Transradial access during coronary angiography has been increasingly used approach for coronary angiography owing to its benefits of lesser vascular complications, reduced patient discomfort, early ambulation and advantage of outpatient angiogram. The procedure is limited by the occurrence of radial vasospasm in 15 to 30% of cases. The study aims to compare rates of radial artery spasm between patients who received pre-procedural Fentanyl versus patients who did not received Fentanyl.
Method: All patients who underwent transradial coronary angiogram from October 2012 to March 2013 were included in the study. Clinical and procedural characteristics of the study subjects including use of Fentanyl were recorded in a database. The presence of RAS was diagnosed by clinical and angiographic method by the operator. Data were presented as percentages for discrete variables and mean ± for SD for continuous variables. Comparison of rate of spasm between the two interventions was carried out using Chi square test. A p value
Results: The population consisted of 158 subjects who underwent transradial coronary angiogram from October 2012 to March 2013. Forty-nine percent (49%) of the patients received pre-procedural Fentanyl while 51% of subjects did not receive Fentanyl. The overall incidence of RAS among the study population is 26.5%. Perceived pain was significantly higher in the subgroup without Fentanyl compared to the Fentanyl group (p 010). The incidence of radial artery spasm is 20.5% in patients given Fentanyl and higher with a 32.5% incidence in patients who did not received Fentanyl. There was a trend towards benefit of Fentanyl in reducing radial artery spasm (p 0.106). Although the clinical end point of RAS did not reach statistical significance, angiographic analysis showed evidence of significant reduction of RAS. Hence, it shows that a single low dose Fentanyl may appear to reduce radial artery spasm.
Conclusion: The use of single low dose of Fentanyl during transradial angiogram showed a trend.towards reduction of radial artery spasm. Although the difference in incidences of RAS is of no statistical significance, the occurrence of pain differ significantly among those given single low dose of Fentanyl versus those who were not given Fentanyl.