{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:28:55Z","timestamp":1787754535079,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background\/Objectives<\/jats:title>\n Pain at the radial access site remains common during coronary angiography. Evidence on topical anesthesia with EMLA patches is inconsistent, and the added value of combining EMLA with local lidocaine infiltration has not been fully clarified. This study compared the analgesic effectiveness of three strategies: EMLA patch, local lidocaine infiltration, and their combination.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this retrospective study, 275 patients undergoing elective transradial coronary angiography received either EMLA patch (\n n<\/jats:italic>\n \u2009=\u200988), local infiltration (\n n<\/jats:italic>\n \u2009=\u200996), or combined EMLA + infiltration (\n n<\/jats:italic>\n \u2009=\u200991). Inclusion required the availability of complete data on pain assessments and access\u2010site complications. Pain intensity during the procedure and over 24\u2009h was assessed using the Numeric Pain Rating Scale at five time points. Group comparisons used the Mann\u2013Whitney\n U<\/jats:italic>\n , Kruskal\u2013Wallis, one\u2010way ANOVA, or chi\u2010square test. Linear regression was applied to identify predictors of pain.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Pain during angiography was lowest with combined anesthesia (median 0 [0\u20131]), compared with EMLA (1 [0\u20132]) or infiltration (3 [1\u20135]) (\n p<\/jats:italic>\n \u2009<\u20090.001). Similar findings were observed for the 24\u2009h cumulative pain score. An EMLA application time of 100\u2013300\u2009min was associated with substantially lower pain than shorter or longer durations (both\n p<\/jats:italic>\n \u2009<\u20090.001). Obesity (BMI\u2009\u2265\u200930\u2009kg\/m\n 2<\/jats:sup>\n ) independently predicted higher procedural pain (B\u2009=\u20090.96;\n p<\/jats:italic>\n \u2009=\u20090.020) and higher 24\u2009h cumulative pain (B\u2009=\u20092.70;\n p<\/jats:italic>\n \u2009=\u20090.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Combined EMLA patch plus local lidocaine infiltration was associated with superior analgesia during and after transradial coronary angiography compared with either method alone. An EMLA application time of 100\u2013300\u2009min may optimize analgesic effectiveness, while patients with obesity may benefit from tailored pain\u2010management strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/clc.70444","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:39:57Z","timestamp":1787571597000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Pain Management With Combined EMLA Patch and Local Anesthetic Infiltration in Transradial Angiography"],"prefix":"10.1002","volume":"49","author":[{"given":"Mohamad Amer","family":"Nashtar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9030-6603","authenticated-orcid":false,"given":"Obayda","family":"Azizy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn","family":"Trippe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Canbay","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hepatology and Gastroenterology, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polykarpos Christos","family":"Patsalis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5452-6687","authenticated-orcid":false,"given":"Martin","family":"Steinmetz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum Ruhr University Bochum Bochum 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