Effect of Papaverine on Left Internal Mammary Artery Flow: Topical Spraying versus Perivascular Injection Method

Abstract Objective: To analyze two techniques of papaverine application, topical spray on the harvested left internal mammary artery (LIMA) and perivascular injection, to find out their ability to improve LIMA flow. Methods: Forty patients were randomized into two groups. In Group 1, papaverine was sprayed on the harvested pedunculated LIMA. In Group 2, papaverine was delivered into the perivascular plane. Drug dosage was the same for both groups. LIMA flow was measured 20 minutes after applying papaverine. Blood flow was recorded for 20 seconds and flow per minute was calculated. The systemic mean pressures were maintained at 70 mmHg during blood collection. The data collected was statistically evaluated and interpreted. Results: The LIMA blood flow before papaverine application in the Group 1 was 51.9±13.40 ml/min and in Group 2 it was 55.1±15.70 ml/min. Statistically, LIMA flows were identical in both groups before papaverine application. The LIMA blood flow, post papaverine application, in Group 1 was 87.20±13.46 ml/min and in Group 2 it was 104.7±20.19 ml/min. The Group 2 flows were statistically higher than Group 1 flows. Conclusion: Papaverine delivery to LIMA by the perivascular injection method provided statistically significant higher flows when compared to the topical spray method. Hence, the perivascular delivery of papaverine is more efficient than the spray method in improving LIMA blood flow.

摘要 目的：对比两种罂粟碱给药方案——对获取的带蒂左胸廓内动脉（left internal mammary artery, LIMA）实施局部喷雾，以及血管周围注射，以探究二者改善LIMA血流的效能。方法：将40例患者随机分为两组。第1组对已获取的带蒂左胸廓内动脉给予罂粟碱喷雾；第2组将罂粟碱注入血管周围间隙。两组给药剂量完全一致。于罂粟碱给药20分钟后测量LIMA血流，记录20秒的血流数据并计算每分钟血流量。血流检测期间维持体循环平均压为70 mmHg。对采集所得数据进行统计学分析与解读。结果：给药前，第1组LIMA血流量为51.9±13.40 ml/min，第2组为55.1±15.70 ml/min，两组基线LIMA血流量无统计学差异。给药后，第1组LIMA血流量为87.20±13.46 ml/min，第2组为104.7±20.19 ml/min，第2组的LIMA血流量显著高于第1组，差异具有统计学意义。结论：与局部喷雾给药方式相比，经血管周围注射罂粟碱可使LIMA血流量获得统计学意义上的显著提升。因此，在改善LIMA血流方面，罂粟碱血管周围给药方案的效能优于局部喷雾给药方式。