What is your standard approach (i.e. choice of medication, type of sheath) in the cath lab to reduce the likelihood of radial artery spasm?   

So important that the patient is comfortable - needs good verbal interaction and adequate sedation. Hydrophilic sheath, vasodilators, and imaging.

Adrenaline is the key vasoconstrictor here, especially in patients with vessels prone to repetitive nicotine-induced constriction, so conscious sedation helps blunt the ‘fright/flight/constrict’ of adrenaline, while a CCB vasodilator (verapamil or nicardipine) addresses local vasoconstri...

Verapamil and nitroglycerin 

We use nitro/verapamil and hydrophilic sheath.

Ultrasound-guided access, hydrophilic sheath, nitroglycerin, and adequate conscious sedation.

Well-informed patient, good sedation, hydrophilic sheath, NTG and Verapamil...