The use of papaverine in arterial sheaths to prevent loss of femoral artery pulse in pediatric cardiac catheterization

This study evaluated the efficacy of intraarterial papaverine infusion after pediatric cardiac catheterization in reducing the incidence of lost pulse. This study was conducted at a teaching pediatric hospital and was designed as a randomized, prospective, double-blind, placebo-controlled study. Pat...

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Bibliographic Details
Published in:Pediatric cardiology 1998-09, Vol.19 (5), p.390-397
Main Authors: Boris, J R, Harned, 2nd, R K, Logan, L A, Wiggins, Jr, J W
Format: Article
Language:English
Subjects:
Cardiac Catheterization
Child
Child, Preschool
Female
Femoral Artery - diagnostic imaging
Femoral Artery - physiopathology
Heart Defects, Congenital - diagnosis
Heart Defects, Congenital - physiopathology
Humans
Infant
Infusions, Intra-Arterial
Male
Muscle, Smooth, Vascular - drug effects
Muscle, Smooth, Vascular - physiology
Papaverine - administration & dosage
Papaverine - pharmacology
Parasympatholytics - administration & dosage
Parasympatholytics - pharmacology
Pulsatile Flow - drug effects
Pulse
Regional Blood Flow - drug effects
Ultrasonography, Doppler
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Summary:This study evaluated the efficacy of intraarterial papaverine infusion after pediatric cardiac catheterization in reducing the incidence of lost pulse. This study was conducted at a teaching pediatric hospital and was designed as a randomized, prospective, double-blind, placebo-controlled study. Patients were children 5 years old or less undergoing antegrade and retrograde heart catheterization. The intervention used was an intraarterial infusion of placebo or 1.5 mg/kg papaverine after catheterization. Bilateral femoral artery ultrasound study was performed pre- and postcatheterization, including two-dimensional, color, spectral, and pulsatility index analysis. Outcome measures included clinical loss of pulse, ultrasound findings, plus other clinical factors. Fifty-six patients participated in the study (28 per group). Six patients clinically lost the pulse in the catheterized arteries [four in the papaverine and two in the placebo groups (p > 0.64)]. Clinical loss of pulse correlated with diminished pulsatility index (p < 0.035). The use of papaverine did not prevent decreased pulse or pulsatility index (p > 0.79). Increased arterial time was the only clinical factor associated with lost pulse (p < 0.0004). Pulsatility index
ISSN:0172-0643
1432-1971
DOI:10.1007/s002469900334