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Comparison between the double-syringe and the single-syringe techniques of adenosine administration for terminating
Praew Kotruchin1, Itchaya-On Chaiyakhan1, Phimonphorn Kamonsri2
1Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Muang, Khon Kaen, Thailand.
Background:
Adenosine has been recommended as a first-line treatment for stable supraventricular tachycardia (SVT). Standard guidelines recommend 6-mg of adenosine administered intravenously (IV) with an immediate 20-ml IV bolus of normal saline solution (NSS; double syringe technique [DST]). However, a newly proposed single-syringe technique (SST), in which adenosine is diluted with an up to 20 ml IV bolus of NSS, was found to be beneficial.
Hypothesis:
We hypothesized that the SST was noninferior to the DST for terminating stable SVT.
Methods:
A pilot multicenter, single-blind, randomized controlled study was conducted at nine hospitals in north and northeast Thailand. Thirty patients who were diagnosed with stable SVT were randomized into two groups of 15, with one receiving adenosine via the DST and the other via the SST. We examined SVT termination, the average successful dose, and the complication rate of each group. Analyses were based on the intention-to-treat principle.
Result:
The termination rate was 93.3% in the DST and 100% in the SST group (p = 1.000), and the success rate of the first 6-mg dose of adenosine was 73.3% and 80%, respectively (p = 1.000). The total administered dose was 8.6 ± 5.1 mg in the DST group and 7.6 ± 4.5 mg in the SST group (p = .608). No complications were found in either group.
Conclusions:
The SST was non-inferior to the DST for termination of SVT. However, a further definitive study with a larger sample size is required.
