Efficacy of Xylocaine and Nitrate Combination in Preventing Radial Artery Spasm and Pain during Transradial Coronary Interventions

Objective: To compare the efficacy of Xylocaine combined with nitrate versus nitrate and placebo in preventing radial artery spasm (RAS) and reducing pain during transradial coronary interventions.Methodology: This study was conducted at Hayatabad Medical Complex, Peshawar, from July to December 2024. A total of 60 patients undergoing transradial coronary procedures were included. Patients were assigned to one of two treatment groups based on clinical considerations: 30 received Xylocaine and nitrate, while 30 received nitrate and placebo. Both patients and interventional cardiologists were blinded to treatment allocation. Radial artery spasm was assessed using a radial spasm score, and pain was measured using the Visual Analog Scale (VAS). Statistical analysis was performed using t-tests and chi-square tests, with significance set at p < 0.05.Results: The Xylocaine and nitrate group had a significantly lower RAS rate (13.3%) compared to the nitrate and placebo group (36.7%) (p = 0.04). Pain scores were also significantly lower in the Xylocaine and nitrate group (2.3 ± 1.2) than in the placebo group (4.1 ± 1.6) (p = 0.01). Procedural duration and nitrate doses were similar between groups.Conclusion: The combination of Xylocaine and nitrate significantly reduces radial artery spasm and procedural pain compared to nitrate and placebo. This double-blind quasi-experimental study supports its clinical utility in improving patient outcomes during transradial coronary interventions.Keywords: Coronary Interventions, Nitrate, Pain Reduction, Radial Artery Spasm, Xylocaine