Effect of Periradial Administration of Papaverine on Radial Artery Diameter

BACKGROUND: Radial artery cannulation is a skillful procedure. An experienced anesthesiologist might also face difficulty in cannulating a feeble radial pulse. AIM: The purpose of the study was to determine whether periradial subcutaneous administration of papaverine results in effective vasodilation and improvement in the palpability score of radial artery. SETTINGS AND DESIGN: Prospective, double-blinded trial. METHODOLOGY: Thirty patients undergoing elective cardiac surgery were enrolled in the study. 30 mg of papaverine with 1 ml of 2% lignocaine and 3 ml of normal saline were injected subcutaneously 1–2 cm proximal to styloid process of the radius. Radial artery diameter before and after 20 min of injection papaverine was measured using ultrasonography. The palpability of the radial pulse was also determined before the injection of papaverine and 20 min later. Patients were monitored for hemodynamics and any complications were noted. STATISTICAL ANALYSIS USED: Student's t-test for paired data. RESULTS: Radial artery diameter increased significantly (P < 0.0001), and the pulse palpability score also showed statistically significant improvement (P < 0.0001) after periradial subcutaneous administration of papaverine. There was no statistically significant difference in heart rate, mean arterial blood pressure before and after papaverine injection. No complications were noted in 24 h of follow-up. CONCLUSION: Periradial subcutaneous administration of papaverine significantly increased the radial artery diameter and pulse palpability score, which had an impact on ease of radial artery cannulation essential for hemodynamic monitoring in cardiac surgical patients.