Conclusion: The use of a single-syringe method for adenosine administration for SVT appears safe and at least as effective as the double-syringe technique for termination of SVT.
- This was a systematic review and meta-analysis of 4 studies (including 3 RCTs) comparing the single-syringe technique of adenosine administration with the traditional double-syringe technique
- Outcomes included termination rate, termination rate at first dose, total administered dose, adverse effects, and discharge rate
- Among a total of 178 patients, no significant differences were noted across groups in most outcomes, including termination rate (77.2% with 2-syringe administration vs 84.9% with single-syringe administration) and total administered dose
- However, the termination rate on first dose was significantly higher among patients who received single-syringe administration (OR, 2.87)
- Limitations:
- All included studies were small and subject to bias
- RCTs were all single-centre
- There was inconsistent reporting and assessment of the outcomes between studies
- IV size and location were not reported and may have impacted termination rate and rate of first attempt success
- Adverse effects could not be fully assessed, because of incomplete reporting in the included studies
- These limitations mean that definitive comparison of the two techniques cannot be drawn, however there was no evidence that the double-syringe technique was more effective
Reference:
Miyawaki IA, Gomes C, Caporal S Moreira V, et al. The single-syringe versus the double-syringe techniques of adenosine administration for supraventricular tachycardia: a systematic review and meta-analysis. Am J Cardiovasc Drugs. 2023;23(4):341-353.
