Article: PDF OnlyRegional intracoronary analgesia during percutaneous transluminal coronary angioplastyAversano, Thomas∗; Walford, Gary D.; Midei, Mark; Chew, Paul; Gottlieb, Sidney O.; Drossner, Michael N.; Weisman, Harlan; Weiss, James L.; Brinker, Jeffery A.Author Information Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205 USA ∗Correspondence to: Thomas Aversano M.D., Division of Cardiology, Johns Hopkins Medical Institutions, Halsted 500, 600 N. Wolfe Street, Baltimore, MD 21205, USA. Submitted July 13, 1992; revised August 24, 1992; accepted August 28, 1992. Pain: January 1993 - Volume 52 - Issue 1 - p 93-99 doi: 10.1016/0304-3959(93)90119-A Buy Metrics Abstract The ischemic pain associated with balloon inflation during coronary angioplasty remains a significant source of procedural discomfort and sets a limit on the duration of percutaneous transluminal intravascular interventions. The present study examined whether intracoronary lidocaine reduced the pain of coronary angioplasty. Sixteen patients undergoing elective coronary angioplasty underwent three 90 sec balloon inflations: the first with administration of no intracoronary agent, and the second and third with administration of one or the other of placebo or an equal volume of lidocaine (10–16 mg). Placebo or lidocaine were randomized in administration sequence and were given just before balloon inflation. During the occlusions, pain was scored on an ordinal scale (0 = no pain; 10 = most severe pain). Lidocaine delayed the onset of pain (23 ± 4 vs. 48 ± 7 sec, P < 0.005) and reduced its magnitude (at end-inflation: 7.8 ± 1.3 vs. 3.2 ± 1.3, P < 0.01). There were no significant hemodynamic or electrophysiologic effects in this group of patients, although atrioventricular conduction was delayed when lidocaine was administered into the epicardial coronary which had the atrioventricular node artery as a branch. Intracoronary analgesia with lidocaine is safe and effective in a select group of patients with normal ventricular function undergoing elective coronary angioplasty. © Lippincott-Raven Publishers.