Direct vasodilation by transdermal administration of nitroglycerin: preliminary, randomized, placebo-controlled trial of nitroglycerin skin spray for premedication before artery puncture.

Purpose: Transdermal administration of nitroglycerin (NTG) before arterial puncture may improve puncture success. The objective of this study was to evaluate the vasodilation effect of NTG skin spray on brachial arteries.

Materials And Methods: We recruited 10 healthy volunteers. On different days and in random order we sprayed their skin above the right or left brachial artery with a solution containing 0.3 mg NTG or above the right brachial artery with physiological saline. A radiologist ultrasonographically measured the cross-sectional area of right brachial artery before and at 5-min intervals for up to 25 min after spraying and calculated the rate of increase of the area.

Results: The average vasodilation rate after spraying with NTG above the right brachial arteries of 10 volunteers was 16.4% at 5 min, 23.6% at 10 min, 19.6% at 15 min, and 16.5% at 20 min; spraying with NTG above the left brachial artery or with physiological saline alone elicited few changes. The vasodilation rate 10 min after spraying with NTG above the right brachial artery was significantly higher than for control groups (P < 0.001).

Conclusions: Transdermal application of NTG spray dilated the targeted brachial artery. This technique may be a good premedication before artery puncture.