Effects of nitroglycerin topical: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major research findings

Nitroglycerin is a vasodilator that has been studied for its potential benefits in various medical conditions. 18 evaluated the effectiveness of nitroglycerin in a rat burn model, suggesting its potential to improve blood flow in burned tissue. 6 describes a case where nitroglycerin injection helped alleviate radial artery spasm during coronary angiography, enabling the removal of an entrapped catheter. 10 reports a successful breast flap salvage using a combination of therapies, including topical nitroglycerin. 9 suggests that nitroglycerin may improve blood flow in the left internal thoracic artery during coronary artery bypass surgery. 4 explores the use of nitroglycerin ointment in treating tissue ischemia caused by hyaluronic acid injection-induced embolism. 8 suggests nitroglycerin ointment may reduce mastectomy flap necrosis in breast reconstruction. 22 reports a case where a nitroglycerin patch successfully alleviated digital ischemia in a preterm infant with sepsis. 7 investigates the potential of nitroglycerin in treating impending filler necrosis. 21 suggests nitroglycerin may be an effective treatment for chronic anal fissures. 11 examines the potential of nitroglycerin to enhance the effectiveness of chemotherapy for rectal cancer. 19 suggests nitroglycerin ointment may be an effective treatment for chronic anal fissures. 24 suggests that topical nitroglycerin can improve blood flow in various types of skin flaps. 17 explored the use of nitroglycerin patches to improve peripheral circulation in children with severe neurodisability. 15 investigated the effect of topical nitroglycerin on random pattern flap perfusion in a rodent model. 25 suggests that nitroglycerin may be an effective treatment for chronic anal fissures. 12 suggests nitroglycerin ointment may be an effective treatment for pediatric anal fissures. 3 examines the potential of nitroglycerin to enhance the activity of antibiotics against Staphylococcus aureus. 14 explores the effectiveness of topical medications, including nitroglycerin, in preventing radial artery spasm during transradial coronary procedures. 26 suggests nitroglycerin ointment may reduce mastectomy flap necrosis in immediate autologous breast reconstruction. 2 compared nitroglycerin to nifedipine for treating hypertensive crisis, finding nitroglycerin to be more effective and preferable. 20 suggests nitroglycerin may be an effective treatment for anal fissures. 28 explores the potential of nitroglycerin to promote wound healing in diabetic foot ulcers. 16 suggests nitroglycerin may be a useful vasodilator in microvascular surgery. 5 reviews the literature on the use of nitroglycerin ointment to treat Raynaud's phenomenon. 23 examines the potential of interventions targeting sphincter spasm to reduce post-hemorrhoidectomy pain. 1 further supports the effectiveness of nitroglycerin in treating hypertensive crises. 13 evaluated the efficacy of nitroglycerin in preventing radial artery spasm and occlusion during and after transradial catheterization.

Benefits and Risks

Benefits Summary

Research suggests that nitroglycerin, when applied topically, has the potential to improve blood flow in various medical conditions, including burns, coronary angiography, breast reconstruction, coronary artery bypass surgery, anal fissures, diabetic foot ulcers, and more. It may also enhance the effectiveness of antibiotics against certain bacteria.

Risks Summary

Nitroglycerin can cause side effects like headaches, dizziness, and palpitations. It can also potentially lead to low blood pressure and increased heart rate. Consulting with a doctor before using nitroglycerin and following their instructions are crucial for safe use.

Comparison between Studies

Commonalities in Studies

Many studies consistently suggest that topical nitroglycerin can promote vasodilation and potentially improve blood flow. It has been studied in a wide range of medical conditions, suggesting its potential versatility.

Differences in Studies

The effectiveness of topical nitroglycerin can vary depending on the specific condition being treated and the method of administration. For example, while some studies show positive effects in treating burns, others focus on its use during coronary angiography or in treating anal fissures. Therefore, understanding the specific application and its potential effects is essential.

Consistency and Contradictions in Findings

While numerous studies suggest the potential benefits of topical nitroglycerin, further research is needed to fully understand its efficacy, safety, and optimal use. The effects of nitroglycerin can vary depending on the specific condition, route of administration, and individual patient factors. It is important to recognize the potential benefits while acknowledging the need for further investigation and understanding the potential side effects.

Practical Implications and Cautions

Topical nitroglycerin shows promise in various medical applications, but it should always be used under a healthcare professional's guidance. Understanding the potential risks and benefits, as well as the specific indications and contraindications, is crucial for its safe and effective use.

Limitations of Current Research

Much of the research on topical nitroglycerin is limited by small sample sizes, animal studies, or a lack of robust clinical trials. Further research is necessary to confirm its effectiveness, optimal dosages, and long-term safety in various clinical settings.

Future Research Directions

Future research should focus on conducting large-scale, well-controlled clinical trials to establish the efficacy and safety of topical nitroglycerin in different medical conditions. The research should explore optimal dosages, delivery methods, and long-term effects. Furthermore, investigating the mechanisms of action and potential interactions with other medications is crucial.

Conclusion

Topical nitroglycerin shows promising potential in various medical applications, primarily due to its vasodilatory properties. However, further research is necessary to solidify its efficacy and ensure its safe and effective use in various clinical settings. Consulting with a healthcare professional is vital for making informed decisions regarding the use of topical nitroglycerin.

Literature analysis of 28 papers
Positive Content
26
Neutral Content
0
Negative Content
2
Article Type
6
5
7
4
26
1.

Comparison of nitroglycerin with nifedipine in patients with hypertensive crisis or severe hypertension.

Author: BussmannW D, KenediP, von MengdenH J, NastH P, RachorN

Hypertension treatment
Increased heart rate

Nitroglycerin is more effective than nifedipine in lowering blood pressure in severe hypertension and hypertensive crisis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

[Nitroglycerin in comparison with nifedipine in patients with hypertensive crisis].

Author: BussmannW D, KenediP, von MengdenH J, NastH P, RachorM

Lowers blood pressure
Treats hypertensive crisis
Side effects

Nitroglycerin was more effective than nifedipine in lowering blood pressure in patients with excessive hypertension and hypertensive crisis. Both drugs had similar effects after 15 to 20 minutes. Nitroglycerin is preferred for hypertensive crisis due to its potential to positively influence associated conditions like left-ventricular failure, pulmonary edema, or angina pectoris.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

5.

Use of nitroglycerin ointment to treat primary and secondary Raynaud's phenomenon: a systematic literature review.

Author: QiuOlivia, ChanTheresa, LuenMatthew, CruzJoseph E, Hermes-DeSantisEvelyn R

RP treatment

Nitroglycerin ointment, a topical nitrate, shows promise for treating Raynaud's phenomenon (RP) and offers a convenient as-needed option for managing unpredictable ischemic attacks. More robust studies are needed to fully understand its efficacy and safety.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Use of ViperSlide Lubricant to Extract Entrapped Sheath after Severe Radial Artery Spasm during Coronary Angiography.

Author: FidoneErica, PriceJustin, GuptaRajiv

Radial artery spasm
Sheath entrapment

This case report describes a rare complication of transradial cardiac catheterization: severe radial artery spasm leading to sheath entrapment. After conventional methods failed, ViperSlide lubricant was successfully used for sheath removal, highlighting its potential benefit in such situations.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Nitroglycerin, or Not, When Treating Impending Filler Necrosis.

Author: CarleySama K, KrausChristina N, CohenJoel L

Necrosis halted
Dermal necrosis

Topical nitroglycerin is a potentially effective treatment for tissue necrosis from soft tissue augmentation, but because data are very limited, it should be used in conjunction with hyaluronidase injections in cases of hyaluronic acid filler dermal necrosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Nitroglycerin Ointment for Reducing the Rate of Mastectomy Flap Necrosis in Immediate Implant-Based Breast Reconstruction.

Author: TurinSergey Y, LiDaniel D, VacaElbert E, FineNeil

Flap necrosis reduction

Nitroglycerin ointment may be effective in reducing the incidence of mastectomy flap necrosis in immediate tissue expander breast reconstruction. A study using 15 g of nitroglycerin ointment per breast found that it may be effective in reducing the incidence of mastectomy flap necrosis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Use of nitroglycerin and verapamil solution by organ bath technique in preparation of left internal thoracic artery for coronary artery bypass surgery.

Author: Ray MohapatraChandan Kumar, MishraPrashant, SaxenaPankaj, RautChaitanya, KhandekarJayant, AmmannayaGanesh Kumar, SethHarsh S, ShahVaibhav, SinghJaskaran

Improved blood flow
Not specified

This prospective study compared the effect of application of nitroglycerin and verapamil solution (GV) by organ bath technique with other methods of applications and solutions on the free blood flow of LITA. GV solution by organ bath technique was effective and superior in comparison to use of papaverine using organ bath technique or topical spray of GV or papaverine solution.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Compromised breast flap treated with leech therapy, hyperbaric oxygen, pentoxifylline and topical nitroglycerin: A case report.

Author: MoffatAndrew D, WeaverLindell K, TettelbachWilliam H

Flap salvage

This case report describes a successful breast flap salvage using a combination of leech therapy, hyperbaric oxygen, topical nitroglycerin, and pentoxifylline.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Phase I dose escalation trial of nitroglycerin in addition to 5-fluorouracil and radiation therapy for neoadjuvant treatment of operable rectal cancer.

Author: IllumHenrik, WangDavid H, DowellJonathan E, HittsonWilliam J, TorrisiJohn R, MeyerJeffrey, HuertaSergio

Rectal cancer treatment

A phase I trial of topical nitroglycerin (NTG) patches in addition to 5-fluorouracil and radiation therapy for rectal cancer found that NTG patches were well-tolerated at the maximum dose examined (0.6 mg/h). A phase II trial is feasible.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Efficacy of nitroglycerine ointment in the treatment of pediatric anal fissure.

Author: JodaAli E, Al-MayoofAli F

This study investigates the safety and efficacy of nitroglycerine (NTG) ointment in treating pediatric anal fissure, a common condition in children. The study aims to provide evidence for the effectiveness of NTG ointment as a conservative treatment option, potentially reducing the need for invasive procedures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

The efficacy of nitroglycerin to prevent radial artery spasm and occlusion during and after transradial catheterization: A systematic review and meta-analysis of randomized controlled trials.

Author: AbdelazeemBasel, AbuelazmMohamed T, SwedSarya, GamalMohamed, AtefMostafa, Al-ZeftawyMohamed A, NooriMuhammad A, LutzAnthony, VolgmanAnnabelle S

Reduced RAO
Reduced RAS
Radial artery occlusion
Radial artery spasm

Subcutaneous nitroglycerin during transradial catheterization was more effective than placebo in preventing radial artery spasm (RAS) and radial artery occlusion (RAO), with risk ratios of 0.57 and 0.39, respectively. Intra-arterial and topical nitroglycerin did not show statistically significant results in preventing RAS and RAO. More research is needed to compare subcutaneous and intra-arterial nitroglycerin administration.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Vasodilation by Verapamil-Nitroglycerin Solution in Microvascular Surgery.

Author: SethRahul, BadranKaram W, CedarsElizabeth, PlonowskaKarolina, BenjaminTania, SaggiSatvir, KnottP Daniel, HeatonChase M, BlackwellKeith E

microvascular surgery

This study investigates the use of a verapamil and nitroglycerin (VG) solution as a potential alternative to papaverine, a vasodilator used in microvascular surgery. The study aims to assess the clinical experience with VG as a pharmacologic vasodilator.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Case series: Use of Glyceryl Trinitrate patches to improve peripheral circulation in children with severe neurodisability.

Author: MorrisonFrances, FairhurstJack, FairhurstCharlie

Peripheral circulation improvement
Ulcer healing
Skin reaction

Topical glyceryl trinitrate (GTN) patches were well tolerated in children with severe complex neurodisability and poor peripheral circulation, improving capillary refill time and comfort. GTN patches may also help heal skin ulcers.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

The effects of nitroglycerin in the zone of stasis in a rat burn model.

Author: GündüzMetin, SekmenliTamer, UğurluoğluCeyhan, Çiftçiİlhan

Burn healing

This study compared the effectiveness of three treatments for the zone of stasis in burn patients. The treatments included an anti-ischemic and vasodilatory agent, a topical agent containing 2% nitroglycerin with 1% silver sulfadiazine, and bacitracin-neomycin sulfate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Efficacy and safety of Propionibacterium extract gel versus glyceryl trinitrate ointment in the treatment of chronic anal fissure: a randomized controlled trial.

Author: GalloGaetano, TrompettoMario, FulginitiSerena, La TorreMarco, TiernoSimone, CantarellaFrancesco, VaniniPaolo, TomasicchioGiovanni, AltomareDonato Francesco, RinaldiMarcella, SantoroGiulio Aniello, CurròGiuseppe, GrossiUgo

Anal fissure healing

Chronic anal fissure (CAF) is a common condition that can cause pain and bleeding. This study compared the efficacy and safety of a Propionibacterium extract gel (PeG) and 0.4% glyceryl trinitrate ointment (GTN) in patients with CAF.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

A systematic review and meta-analysis of the efficacy of topical sphincterotomy treatments for anal fissure.

Author: JinJames Z, HardyMolly-Olivia, UnasaHanson, Mauiliu-WallisMelbourne, WestonMaree, ConnollyAndrew, SinghPrimal Parry, HillAndrew G

Anal fissure healing
Pain reduction
Headache
Side effects

Topical nitrates (glyceryl trinitrate [GTN]) were more effective than placebo in healing anal fissures, with a relative risk (RR) of 1.96 (95% CI 1.35-2.84). GTN also reduced pain but was associated with a higher risk of headache. More evidence is needed to determine the effectiveness of topical diltiazem.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Clinical Outcomes of Medical Management Options for Chronic Anal Fissures in a Long-Term Follow-up: Systematic Review and Meta-Analysis.

Author: Sierra-ArangoFernando, de la Hoz-ValleJosé, EspinosaJuan Pablo, Moreno-MontoyaJosé, Vásquez RoldanMariana, Pérez-RiverosErika D

CAF treatment

This meta-analysis evaluates the long-term effectiveness of medical treatments for chronic anal fissures (CAF) in adults. The study examines the effectiveness of calcium antagonists, nitroglycerin, and botulinum toxin injections, which are currently considered valid treatment options for CAF.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Nitroglycerin patch use in digital ischemia secondary to sepsis: a case report.

Author: JadhavDevendrasing Vijaysing, MendoncaDerek, KotinatotSuresh, ShankarShiva, MazmiMunira Al

Treats sepsis

This case report presents a preterm infant with acute digital ischemia and impending gangrene as a manifestation of sepsis. The infant successfully received treatment with a topical nitroglycerin patch, avoiding the need for surgery or other interventions.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

23.

Can Targeting Sphincter Spasm Reduce Post-Haemorrhoidectomy Pain? A Systematic Review and Meta-Analysis.

Author: JinJames, UnasaHanson, BahlPraharsh, Mauiliu-WallisMelbourne, SvirskisDarren, HillAndrew

Reduced pain
Incontinence

This study reviews evidence behind interventions aimed at lowering internal anal sphincter spasm to relieve post-haemorrhoidectomy pain. It finds evidence that lateral sphincterotomy, botulinum toxin, and topical diltiazem or glyceryl trinitrate can reduce post-operative pain after haemorrhoidectomy. However, lateral sphincterotomy should not be routinely used due to the risk of incontinence.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Short-term Results of Platelet-Rich Plasma in the Treatment of Chronic Anal Fissure: Randomized Controlled Clinical Study.

Author: YilmazGökhan, TanrikuluYusuf

Accelerated healing
Reduced pain

Platelet-rich plasma reduced pain and accelerated epithelialization and healing in patients with chronic anal fissures compared to topical glyceryl trinitrate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Video-Audio MediaMedia that combines video and audio. Includes movies, TV shows, and online videos.

Language : English

26.

Topical Nitroglycerin Ointment Reduces Mastectomy Flap Necrosis in Immediate Autologous Breast Reconstruction.

Author: YaoAmy, GreigeNicolas, RicciJoseph A, DraperLawrence B, WeichmanKatie E

MFN prevention

Mastectomy flap necrosis (MFN) is a serious complication of breast reconstruction. This article examines the potential benefits of topical nitroglycerin ointment for preventing MFN in immediate autologous breast reconstruction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

27.

Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy - systematic review and meta-analysis.

Author: SaltychevMikhail, JohanssonJouni, KemppiViljami, JuholaJuhani

Topical glycerin trinitrate (NTG) is not more effective than placebo in reducing pain in tendinopathy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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