NDLI: Prospective, randomized, double-blind controlled trial comparing vapocoolant spray vs placebo spray in adults undergoing venipuncture.

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Prospective, randomized, double-blind controlled trial comparing vapocoolant spray vs placebo spray in adults undergoing venipuncture.

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Prospective, randomized, double-blind controlled trial comparing vapocoolant spray vs placebo spray in adults undergoing venipuncture.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mace, Sharon E.
Description	Author Affiliation: Mace SE ( Department of Emergency Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, MetroHealth Medical Center Emergency Medicine Residency, Research, Emergency Services Institute, Cleveland Clinic, Cleveland, OH. Electronic address: maces@ccf.org.)
Abstract	INTRODUCTION: Topical anesthetics are used to decrease procedural pain such as venipuncture. Advantages of vapocoolants include rapid onset, ease of application, low cost, and lack of associated pain of injection and other needlestick-related risks. We hypothesized that the pain of venipuncture would be reduced by at least 1.8 points on a 10-point numerical rating scale after application of a vapocoolant compared with placebo. METHODS: We conducted a prospective, randomized, double-blind controlled trial of vapocoolant vs placebo spray in 100 adults (ages 18-80) requiring venipuncture in a hospital emergency department or observation unit. The primary efficacy outcome was the difference in pain scores immediately after venipuncture, measured on a 10-point verbal numeric rating scale from 0 (none) to worst (10). Safety outcomes included local adverse effects (edema, erythema, blanching) and changes in vital signs (VS). RESULTS: Patient characteristics and venipuncture procedure were not significantly different for the 2 groups. The median (interquartile range) pain of venipuncture was 3 (1.2-5) in the placebo group and 1 (0-3) in the vapocoolant group, P < .001. Skin checklist revealed the following: vapocoolant-minimal blanching 4%, minimal erythema 18% which resolved within 5 minutes; placebo-no visible skin changes. Photographs at 5 to 10 minutes revealed no visible skin changes in any patient. There were 2 complaints: 'very wet and cold on skin' (placebo) and 'felt burning on skin' (vapocoolant). CONCLUSION: The vapocoolant significantly decreased venipuncture pain in adults compared with placebo and was well tolerated with minor adverse effects that resolved quickly. There were no significant differences in VS and no visible skin changes documented at the site by photographs taken within 5 to 10 minutes postspray/venipuncture.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	34
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2016-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Anesthetics, Local Therapeutic Use Pain Prevention & Control Phlebotomy Adverse Effects Adolescent Adult Aerosols Aged Aged, 80 And Over Double-blind Method Female Humans Male Middle Aged Etiology Pain Measurement Prospective Studies Treatment Outcome Young Adult Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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