WCC Conference Abstracts

Objectives: e trans-radial approach (TRA) is now the preferred route for coronary angiography and percutaneous coronary intervention, as it has been shown to be associated with better survival and better quality of life However, the small caliber and the associated spasm-prone nature of the radial artery is often hinderance for such TRA especially in females.e sympathetic innervation of the radial artery through the median nerve suggests that a median nerve block may induce sustained vasodilation and reduce radial spasm.We aimed to evaluate the effect of a median nerve block on radial artery diameter and procedural comfort in patients undergoing elective coronary angiography or angioplasty. Material and Methods:Our study is an investigator-initiated, randomized, single-blinded, controlled clinical trial that included 100 adult patients (American Society of Anesthesiologists II-III, aged 40-65 years) scheduled for elective coronary angiography or angioplasty.Participants were randomized into two groups: Group M (n = 50): Received ultrasound-guided median nerve block and lateral cutaneous nerve blocks using a mixture of 2% lignocaine and 0.5% bupivacaine, and Group L (n = 50): Received local anesthetic infiltration at the radial puncture site.e primary outcomes of the study were the mean diameter of the radial artery at 30 min after the median nerve block.Radial artery diameter (horizontal, vertical, and crosssectional area) was also measured using a high-frequency linear ultrasound probe at baseline and at 5, 10, 15, and 30 min post intervention.Pain was assessed using the Visual Analog Scale.Results: e mean diameter of the radial artery was significantly larger in group M as compared to group L. Both vertical and horizontal diameters were significantly larger in Group M at all-time points after the block.e mean cross-sectional area of the radial artery increased by approximately 30% in Group M (8.14 2.26 mm 2 ) compared to Group L (5.80 1.24 mm 2 ; P < 0.0001).Pain scores during sheath insertion and post-procedure were significantly lower in Group M with a median 2, compared to a median 4 in Group L P < 0.0001).e requirement for additional sedation was also lower in Group M (4%) than in Group L (24%; P = 0.008).No major complications were reported. Conclusion:Ultrasound-guided median nerve block significantly increases radial artery diameter and reduces procedural pain, improving the safety and comfort of trans radial coronary interventions.