الفهرس 
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Abstract
This work aimed to investigate the possible advantage of topical lidocaine and / or intravenous midazolam in the prevention of radial artery spasm and pain.
Methods: This prospective comparative interventional study included 120 patients planned for elective coronary interventions. Patients were randomized into four groups; group I included patients administered a cocktail of nitroglycerine, verapamil and heparin through the sheath or intravenously (control group), group II included patients administered the control cocktail plus topical lidocaine, group III included patients those administered the control cocktail plus midazolam intravenously and group IV included patients administered the control cocktail, topical lidocaine and intravenous benzodiazepines.
Results: Radial artery spasms occurred in 22 patients (18.3%), with a higher incidence in the control group (40%). Statistically significant differences were demonstrated among the groups in the incidence of radial artery spasm, the median VAS values, the incidence of requirement multiple punctures, and the number of indicated punctures. Access site cross-over was higher in the control group. Age, complication rates, VAS score, the incidence of multiple punctures and the puncture time were significantly higher in patient with RAS.
Conclusion: Coronary interventions through trans-radial approach could be safe and feasible after proper medications to diminish radial artery spasm.