Ointment therapy and prevention of cannulation-induced superficial phlebitis


The primary aim of this prospective randomized trial is to determine the effect of clobetasol ointment with nitroglycerin ointment on the prevention of phlebitis caused by cannulation. The target sample is 144 patients admitted to surgical ward, randomized to 3 groups. the data collection tools included demographic information, information about intravenous treatment and phlebitis measurement scale. In the intervention groups, after venipuncture, 1.5 cm of ointments (clobetasol and nitroglycerin) was applied n three time periods of 24, 48 and 72 hours from the time of venipuncture. In the first 24 hours after cannulation, there was no significant difference between the three groups. But at 48 and 72 hours after placement, the difference between intervention and control groups was significant (P<0.0001). It is recommended to use clobetasol ointment and nitroglycerin ointment to prevent the occurrence of phlebitis in patients who need long-term use of cannula (more than 48 hours).



PlumX Metrics


Download data is not yet available.


Dandekar VK, Vidovich MI, Shroff AR. Complications of transradial catheterization. Cardiovasc Revasc Med 2012;13:39-50. DOI: https://doi.org/10.1016/j.carrev.2011.08.005

Wang L, Yang Y, Zhou Y, et al. Prevalence of transradial coronary angiography and intervention in China: report from the Transradial coronary intervention Registration Investigation in China (TRI-China). Int J Cardiol 2010;145:246-7. DOI: https://doi.org/10.1016/j.ijcard.2009.08.027

Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. The Lancet 2011;377:1409-20. DOI: https://doi.org/10.1016/S0140-6736(11)60404-2

Drake R, Vogl AW, Mitchell AW. Gray’s Anatomy for Students E-Book: Elsevier Health Sciences; 2009.

Tewari S, Sharma N, Kapoor A, et al. Comparison of transradial and transfemoral artery approach for percutaneous coronary angiography and angioplasty: a retrospective seven-year experience from a north Indian center. Indian Heart J 2013;65:378-87. DOI: https://doi.org/10.1016/j.ihj.2013.06.020

Michael TT, Alomar M, Papayannis A, et al. A randomized comparison of the transradial and transfemoral approaches for coronary artery bypass graft angiography and intervention: the RADIAL-CABG Trial (RADIAL Versus Femoral Access for Coronary Artery Bypass Graft Angiography and Intervention). JACC Cardiovasc Intervent 2013;6:1138-44. DOI: https://doi.org/10.1016/j.jcin.2013.08.004

Hibbert B, Simard T, Wilson KR, et al. Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese. JACC Cardiovasc Intervent 2012;5:819-26. DOI: https://doi.org/10.1016/j.jcin.2012.04.009

Mason PJ, Shah B, Tamis-Holland JE, et al. An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association. Circulation Cardiovasc Intervent 2018;11:e000035. DOI: https://doi.org/10.1161/HCV.0000000000000035

Ibebuogu UN, Cercek B, Makkar R, et al. Comparison between transradial and transfemoral percutaneous coronary intervention in acute ST-elevation myocardial infarction. Am J Cardiol 2012;110:1262-5. DOI: https://doi.org/10.1016/j.amjcard.2012.06.024

Balwanz CR, Javed U, Singh GD, et al. Transradial and transfemoral coronary angiography and interventions: 1-year outcomes after initiating the transradial approach in a cardiology training program. Am Heart J 2013;165:310-6. DOI: https://doi.org/10.1016/j.ahj.2012.10.014

Schussler JM, Vasudevan A, Liana J, et al. Comparative efficacy of transradial versus transfemoral approach for coronary angiography and percutaneous coronary intervention. Am J Cardiol 2016;118:482-8. DOI: https://doi.org/10.1016/j.amjcard.2016.05.038

Iwachow P, Miechowicz I, Kałmucki P, et al. Evaluation of radiological risk during coronary angioplasty procedures: comparison of transradial and transfemoral approaches. Int J Cardiovasc Imaging 2017;33:1297-303. DOI: https://doi.org/10.1007/s10554-017-1130-2

CRSaS. The optimal arterial access for coronary angiography: femoral route versus radial route. J Vasc Med Surg UK 2016;3. DOI: https://doi.org/10.4172/2329-6925.1000271

Heartwire LN. Surgery is best for most patients, final SYNTAX data confirm. Medscape 2012;2012.

Samady H, Eshtehardi P, McDaniel MC, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease. Circulation 2011;124:779-88. DOI: https://doi.org/10.1161/CIRCULATIONAHA.111.021824

Goff DC, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2935-59. DOI: https://doi.org/10.1016/j.jacc.2013.11.005

Glineur D, D’hoore W, De Kerchove L, et al. Angiographic predictors of 3-year patency of bypass grafts implanted on the right coronary artery system: a prospective randomized comparison of gastroepiploic artery, saphenous vein, and right internal thoracic artery grafts. J Thoracic Cardiovas Surg 2011;142:980-8. DOI: https://doi.org/10.1016/j.jtcvs.2011.07.017

Popovsky MA, Ilstrup DM. Randomized clinical trial of transparent polyurethane iv dressings. J Infusion Nurs 1986;9:107-10.

Saleh Moghadam Ar, Vahedian Azimi A, Rezaei Adriani M. The effect of 2% nitroglycerin ointment application on the phlebitis intensity, induced by intravenous catheter. Shahrekord Univ Med Sci J 2009;11(2):-.

Avazeh A, Elahi N. The effect of topical nitroglycerin on the incidence and severity of venous catheter phlebitis. J Adv Med Biomed Res 2004;12(47):-

Tjon JA, Ansani NT. Transdermal nitroglycerin for the prevention of intravenous infusion failure due to phlebitis and extravasation. Ann Pharmacother 2000;34:1189-92. DOI: https://doi.org/10.1345/aph.18188

Dvir E, Russo S, Meshorer A, et al. Clobetasol 17-propionate cream as an effective preventive treatment for drug induced superficial thrombophlebitis. Scand J Lab Animal Sci 2009;36:123-30.

Kohno E, Murase S, Matsuyama K, Okamura N. Effect of corticosteroids on phlebitis induced by intravenous infusion of antineoplastic agents in rabbits. Int J Med Sci 2009;6:218. DOI: https://doi.org/10.7150/ijms.6.218

Aslani Y. Phlebitis caused by peripheral venous catheter in patients of medical and surgical wards in Hajar & Kashani hospitals, Shahrekord. Shahrekord Univ Med Sci J 1999;1.

Macklin D. Phlebitis: A painful complication of peripheral IV catheterization that may be prevented. AJN Am J Nurs 2003;103:55-60. DOI: https://doi.org/10.1097/00000446-200302000-00027

Avazeh A, Elahi N, Asadizaker M, et al. Effect of topical nitroglycerin on the occurence and severity of phlebitis due to indwelling intravenous catheter in hospitalized patients. J Adv Med Biomed Res 2004;12:47.

Ghadami A. The study of prevalence rate of phlebitis and comparing the risk of it among clients according to inserting time of intravenous equipments during 24,48,72 and 96 hours. Arak Med Univ J (Amuj) 2001;3(4 (13)):-.

Karadag A, Görgülü S. Devising an intravenous fluid therapy protocol and compliance of nurses with the protocol. J Infus Nurs 2000;23:232-8.

Raziani Y, Raziani S. Investigating the predictors of overweight and obesity in children. Int J Adv Stud Human Social Sci 2020;9:262-80.

Original Articles
Patient, clobetasol ointment, nitroglycerin ointment, phlebitis, angio catheter.
  • Abstract views: 408

  • PDF: 62
How to Cite
Raziani, Y., & Othman, B. S. (2021). Ointment therapy and prevention of cannulation-induced superficial phlebitis. Veins and Lymphatics, 10(2). https://doi.org/10.4081/vl.2021.9800