Læknablaðið - 15.10.1982, Side 29

LÆKNABLADID
241
hefur veriö skrifað um þetta efni (4, 5, 6), en
litlar heimildir eru um samanburð á aukaverk-
unum Metrizamid annars vegar og skugga-
gjafa með deyfandi lyfi hins vegar. í>að liggur
ekki ljóst fyrir, hvort hinn mikli verðmunur
þessara tveggja aðferða skili sér að fullu í
minni tíðni aukaverkana hjá Metrizamid. (15).
Af hagkvæmnisástæðum hafa Angiografin
og Lidocain nokkra kosti fram yfir Metriza-
mid. Hvorttveggja eru upplausnir tilbúnar til
notkunar, en Metrizamid fæst ennþá eingöngu
sem þurrfrosið duft í hettuglösum. Til þess að
ná tilætluðu magni og styrkleika verður að
leysa innihaldið úr 4 hettuglösum upp í ákveðnu
magni af saltvatni og tekur það sinn tíma.
Síðan þarf að draga hverja tilbúna upplausn
fyrir sig upp í þrýstisprautuna.
Innspýting á Angiografin með Lidocain 2 %
býður upp á hagkvæma, áreiðanlega, örugga,
ódýra og fyrir sjúklingana óþægindalitla rann-
sókn á útlimaæðum.
Greinarhöfundur þakkar starfsfólkinu á Lab 1, Röntgen-
deild Landspítalans fyrir auðsýndan áhuga og aðstoð við
framkvæmd könnunarinnar.
SUMMARY
In a crossover study of 28 patients referred for
peripheral arteriography of the lower extremities
the side effects of Metrizamid and a conventional
contrast medium Angiografin with Lidocain was
compared. Of 12 patients who were administered
Angiografin with Lidocain 1 %, 2 patients complain-
ed of severe heat and two made involuntary
movements of pain whereas no patient was visibly
distressed after the administration of Metrizamid.
Statistically a difference in favour of Metrizamid (P:
0.047). In a second group of 16 patients who
received Lidocain 2 % with the Angiografin, only
one patient showed obvious signs of pain but none
of those who got Metrizamid (P: 0.5).
Only 3 patients in both groups experienced
severe side-effects after the administration of Angi-
ografin with Lidocain. All three patients had occlusi-
on of at least one main artery and extensive
collateral circulation.
Taking into consideration the much higher price
of Metrizamid, the Angiografin-Lidocain 2 % com-
bination is to be preferred.
HEIMILDIR
1. Pond, Gerald D., Osborne, Robert W., Capp,
Paul M. et al.: Digital Substraction Angiography
of Peripheral Vascular Bypass procedures. Am.
]. Roentgenol. 1982, 138, 279-281.
2. Hilal, S.K.. Hemodynamic changes associated
with the intraarterial injection of contrast me-
dia. New toxicity tests and a new experimental
contrast medium. Radiology. 1966, 86, 615-633.
3. Metrizamide-Amipaque. The non-ionic water-
soluble contrast medium. Further clinical expe-
rience in Neuroradiology. Edited by Erik Lind-
gren. Acta Radiologica. 1977. Supplementum
355.
4. Almen, T., Bojsen, E., Lindell, S. E.: Metrizamide
in Angiography. Femoral Angiography. Acta
Radiol. (Diag). 1977, 18:33-38.
5) Amipaque Vascular. Proceedings of a Symposi-
um, Amsterdam. Diagnostic Imaging. 1979. 48:
181-256.
6. Idbohrn, H. Movin, Anders. Klinisk prövning av
Metrizamid vid Femoralis arteriografi. Lakar-
tidningen. 1980. 77: 2807-2808.
7. Grainger, R. G. A clinical trial of a new low
osmolality contrast medium-Hexabrix. British
Journal of Radiology. 1979. 52: 781-786.
8. Grainger, R.G. Intravascular contrast media, the
past, the present and the future. Mackenzie
Davidson Memorial Lecture April 1981. British
Journal of Radiology. 1982. 55: 1-18.
9. Molyneux, A. J., Sheldon, W.E. A. randomized
blind trial of lopamidol and Meglumine Calcium
Metrizoate (Triosil 280, Isopaque Cerebral) in
cerebral angiography. British Journal of Radio-
logy. 1982. 55:117-119.
10. Siefert, H.M. et al. Iotasul, a water-soluble
contrast agent for direct and indirect lympho-
graphy. Lymphology. 1980. 13: 150-157.
11. Fletcher, E.W.L. A comparison of Iopamidol and
Diatrizoate in peripheral angiography, British
Journal of Radiology 1982. 55: 36-38.
12. Riba, P.O., Notkun á Lidocain í slagæð við
skoðun á útlimaæðum með skuggagjafa. Læ-
knablaðið. 1979.3: 133-136.
13. Gordon, L. J., Westscott, J.L.: lntraarterial Lido-
cain: An effective analgesic for peripheral
Angiography. Radiology. 1977. 124:43-45.
14. Schmidt, K.R., Pfeifer, K.J. Effektivitat von
intraarteriellem Lidocain in der Schmerzbe-
kampfung bei Arm-und Bein arteriographien.
Munch. med Wschr. 122. 1980. 34: 1159-1162.
15. Schmidt, K.R., Pfeifer, K.J., Hubert, R., Welter,
H. Schmerzreduktion bei peripheren Arterio-
graphien der oberen und unteren Extremitát in
Doppelblindversuch. Lidocain/Ioglicinat gegen
Metrizamid. Röntgen-BI. 1980. 33: 571-576
16. Foldes, F.F., Molloy, RE., Mc Nall, PG. et al.
Comparison of Toxicity of intravenously given
local anesthetic agents in man. JAMA. 1960. 172:
1493-1448.
17. Chuang, V.P., Widrich, W.C. Complications from
intraarterial Lidocaine in Upper Extremity Ar-
teriography. Am. J. Roentgenol. 1978. 131: 906.
18. Widrich, W.C., Singer, R.J., Robbins, A.H. The
use of intra-arterial Lidocaine to control pain
due to Aortofemoral Arteriography. Radiology.
1977. 124:37-41.