Læknablaðið - 15.06.1984, Side 45

LÆK.NABLADID
175
og aukaverkanaminnstu læknisþjónustu sem
völ er á hverju sinni. Notkun lidocaíns í æð
samfara inndælingu jónaðs skuggagjafa, getur
pó minnkað sjúklingum óþægindi við rann-
sókn á útlimaæðum, sé ekki annarra kosta völ.
Starfsfólki á stofu 1, Röntgendeild Landspítalans og Kjart-
ani Pálssyni hjartasérfræöingi, er pökkuð aðstoð við könn-
unina og úrlestur hjartalínurita.
SUMMARY
Iohexol, a new non-ionic low-osmolar contrast
medium, was compared to the conventional ionic
hyperosmolar contrast medium Angiografin with
Lidocain in a randomized double-blind cross-over
study of aortofemoral angiographies of 30 patients.
The patients were evaluated for signs of discomfort
and the intraarterial blood pressures, the pulse rate
and the ECG, were monitored continously. Iohexol
caused significantly less haemodynamic changes
than Angiografin with Lidocain whereas no signifi-
cant difference between the two contrast agents
was found for either pain or warmth. With the
present knowledge of the damaging effects of the
hyperosmolar contrast media on the vascular bed it
now seems advisable whenever possible and costs
permitting to replace the conventional hyperosmo-
lar contrast media by the less osmolar contrast
agents in angiography, especially in aortofemoral
angiography of ischemic legs. To reduce the incom-
fortable side-effects of the hyperosmolar contrast
media in angiography of the lower extremities, the
alternative of using Lidocain simultaneously is still
possible.
The authors are indebted to Nyegaard & Co,
Oslo, for supplying the contrast medium and proto-
cols used for this study.
HEIMILDIR
1) Grainger RG. Intravascular contrast media, the
past, the present and the future. Mackenzie
Davidson Memorial Lecture April 1981. British
Journal og Radiology 1982; 55: 1-18.
2) Hilal SK. Hemodynamic changes associated
with the intraarterial injection of contrast
media. New toxicity tests and a new experimen-
tal contrast medium. Radiology 1966; 86: 615-
33.
3) Raininko R. Role of hypertonicity in the end-
othelial injuri caused by angiographic contrast
media. Acta Radiologica Diagn. 1979; 20: 410-
16.
4) Amipaque Vascular. Proceedings of a Symposi-
um, Amsterdam. Diagnostic Imaging 1979; 48:
181-256.
5) 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.
6) Iohexol. A non-ionic contrast medium. Pharma-
cology and toxicology. Edited by Erik Lindgren.
Acta Radiologica. 1980. Supplementum 362.
7) Egsgaard H, Hörup A, Praestholm J. A control-
led Clinical trial of Iohexol and Diatrizoate in
Aortofemoral Angiography. Europ Journal og
Radiology 1983; 3: 14-6.
8) Widrich WC, Singer RJ, Robbins AH. The use
of intraarterial Lidocaine to control pain due to
Aortofemoral Arateriography. Radiology 1977;
124:37-41.
9) Riba PO. Notkun á Lidocain í slagæð við
skoðun á útlimaæðum með skuggagjafa.
Læknablaðið 1979; 65: 133-6.
10) Gordon LJ, Westscott JL. Intraarterial Loidoca-
in: An effective analgesic for peripheral Angio-
graphy. Radiology 1977; 124: 43-5.
11) Riba PO. Æðarannsókn á útlimum. Samanburð-
ur á Metrizamid og Angiografin med Lidocain.
Læknablaðið 1982; 68: 239-41.
12) Bettman M, Paulin S. Leg Phlebography; The
incidence Nature and Modifications of undes-
irable sideeffects Radiology 1977; 112: 101-4.
13) Grainger RG. A clinical trial of a new low
osmolality contrast medium — Hexabrix. Bri-
tish Journal of Radiology. 1979; 52: 781-6.
14) Widrich WC, Beckman Carl F, Robbins Alan H
et al. Iopamidol and Meglumine Diatrizote:
Comparison of Effects on Patient Discomfort
during Aortofemoral Arteriography. Radiology
1983; 148:61-4.
15) Schmidt KR, Pfeifer KJ, Hubert R, Welter H.
Schmerzreduktion bei peripheren Arteriograp-
hien der oberen und unteren Extremitát in
Doppelblindversuch. Lidocain/Ioglicinat gegen
Metrizamid. Röntgen-bl. 1980; 33: 571-6.
16) Nilsson P, Almén T, Golman K et al. Malmö
Sweden: Should local anaesthetics be mixed
with contrast media in aortofemoral angiograp-
hy. Paper read at the 41st Congress of Medical
Radiology, Reykjavík 1982. (Text in Swedish).