Contrast media and pain: hypotheses on the genesis of pain occurring on intra-arterial administration of contrast media
Hagen, B.; Klink, G.
Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. Erganzungsband 118: 50-56
1983
ISSN/ISBN: 0178-4609 PMID: 6139080 Document Number: 5137
It has been found that certain physiochemical properties of the contrast media in common use are responsible for the sensations of pain and heat which occur on intravascular administration. Not only the chemotoxicity, but also and in particular the high osmolality of ionic, monomeric contrast media plays an important role in the genesis of such local side effects, as has been convincingly demonstrated in numerous clinical and animal studies. Of the various theories on the origin of pain, vascular spasm and vasodilation are of more historical importance as causative factors. Recently gained histomorphological and neurophysiologic knowledge suggests that biochemical mechanisms play a primary role. A synoptic model is described which - in analogy to the processes in inflammatory and anaphylactic phenomena - conceives contrast medium induced pain as a cascade of biochemical processes taking place in the terminal vascular system and leading to depolarization of paravascular neuroreceptive terminals (chemosensitive receptor field).
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