Vapocoolant spray for intravenous cannulation pain: a Prospective, randomized controlled trial

Yıl 2021, Cilt: 31 Sayı: 3, 295 - 298, 20.09.2021

Fatih Selvi Cihan Bedel Mehmet Akçimen

https://doi.org/10.54005/geneltip.989829

Öz

Introduction: Peripheral intravenous (IV) cannulation are routine procedures in emergency department (ED) admissions. Vapocoolant sprays have a potential advantage over other topical agents.We aimed to see how effective vapocoolant spray was in reducing pain during intravenous cannulation versus a control group in this study.
Materials and Methods: This is a prospective, randomized control study consisting of patients who were admitted to the ED. The study included patients aged 18 and over who applied to the ED and had IV cannulation. The patients were divided into 2 groups as control and vapocoolant spray groups. Age, gender, and dominant hand status of all patient groups were recorded. Side effects were observed after the application. The Visual Analogue Scale (VAS), which is the most widely used scale to measure pain, was used.
Results: 206 individuals were randomized. The mean age of the vapocoolant spray group was 46.40±16.44 years, while it was 46.75±17.49 years for the control group. The vapocoolant spray group was found to have significantly lower mean VAS values during IV cannulation than the control group (1.47±1.32 vs. 3.97±1.97 p<0.001). It was found that the vapocoolant spray-applied group had a significantly lower percentage in terms of moderate pain (VAS>3 cm) compared to the control group (7.8% vs 58.3%, p<0.001). Besides, the percentage of severe pain (VAS>5.4 cm) in the spray-applied group was found to be significantly lower than the control group (1% vs. 20.4%, p<0.001).
Conclusion: The vapocoolant spray can be used effectively to mitigate the pain associated with the pre-IV cannulation procedure and can be an alternative method for reducing pain in emergency departments.

Anahtar Kelimeler

Intravenous cannulation, pain, vapocoolant spray

İntravenöz Kanülasyon Ağrısı İçin Vapocoolant Sprey: Prospektif, Randomize Kontrollü Bir Çalışma

Öz

Amaç: Periferik intravenöz (IV) kanülasyon, acil servis (ED) başvurularında rutin prosedürlerdir. Vapocoolant spreylerin diğer topikal ajanlara göre potansiyel bir avantajı vardır. Bu çalışmada bir kontrol grubuna kıyasla intravenöz kanülasyon sırasında ağrıyı azaltmada vapocoolant spreyin ne kadar etkili olduğunu görmeyi amaçladık.
Materyal-Metod: Bu, acil servise kabul edilen hastalardan oluşan prospektif, randomize bir kontrol çalışmasıdır. Çalışmaya acil servise başvuran ve IV kanülasyon yapılan 18 yaş ve üzeri hastalar dahil edildi. Hastalar kontrol ve vapocoolant sprey grubu olarak 2 gruba ayrıldı. Tüm hasta gruplarının yaş, cinsiyet ve baskın el durumu kaydedildi. Uygulamadan sonra yan etkiler gözlendi. Ağrıyı ölçmek için en yaygın kullanılan ölçek olan Görsel Analog Skala (VAS) kullanıldı.
Bulgular:206 kişi randomize edildi. Vapocoolant sprey grubunun yaş ortalaması 46,40±16,44 yıl, kontrol grubu içinse 46,75±17,49 yıl idi. Vapocoolant sprey grubunun, IV kanülasyon sırasında kontrol grubuna göre önemli ölçüde daha düşük ortalama VAS değerlerine sahip olduğu bulundu (1,47±1,32'ye karşı 3,97±1,97 p<0,001). Vapocoolant sprey uygulanan grubun orta şiddette ağrı (VAS>3 cm) açısından kontrol grubuna göre anlamlı olarak daha düşük bir yüzdeye sahip olduğu bulundu (%7,8'e karşı %5,3, p<0,001). Ayrıca sprey uygulanan grupta şiddetli ağrı yüzdesi (VAS>5,4 cm) kontrol grubuna göre anlamlı derecede düşük bulundu (%1'e karşı %20,4, p<0,001).
Sonuç: Vapocoolant sprey, IV öncesi kanülasyon prosedürüne bağlı ağrıyı azaltmak için etkili bir şekilde kullanılabilir ve acil servislerde ağrıyı azaltmak için alternatif bir yöntem olabilir.

Anahtar Kelimeler

Periferik intravenöz kanülasyon, ağrı, buhar soğutucu sprey

Kaynakça

• 1. Zempsky WT. Pharmacologic approaches for reducing venous access pain inchildren. Pediatrics 2008; 122: 140–53.
• 2. Mura P, Serra E, Marinangeli F, et al. Prospective study on prevalence, intensity, type, and therapy of acute pain in a second-level urban emergency department. J Pain Res 2017; 10: 2781-8.
• 3. Ducharme J. Acute Pain Management in the year 2018-a review. J Acute Med 2018; 8: 53-9.
• 4. Mace SE. Prospective, randomized, double-blind controlled trial comparing vapocoolant spray vs placebo spray in adults undergoing venipuncture. Am J Emerg Med 2016; 34: 798-804. 5. Zempsky WT. Pharmacologic approaches for reducing venous access pain in children. Pediatrics 2008; 122: 140–53.
• 6. Hogan ME, Smart S, Shah V, Taddio A. A systematic review of vapocoolants for reducing pain from venipuncture and venous cannulation in children and adults. J Emerg Med 2014; 47: 736-49.
• 7. Barbour T, O'Keefe S, Mace SE. Patient and health care provider responses from a prospective, double-blind, randomized controlled trial comparing vapocoolant spray versus placebo spray in adults undergoing venipuncture in the emergency department. Pain Manag Nurs. 2018; 19: 391-9.
• 8. Unal N, Tosun B, Aslan O, Tunay S. Effects of vapocoolant spray prior to sc lmwh ınjection: an experimental study. Clinical Nursing Research 2021; 30: 127-34.
• 9. Dalvandi A, Ranjbar H, Hatamizadeh M, Rahgoi A, Bernstein C. Comparing the effectiveness of vapocoolant spray and lidocaine/procaine cream in reducing pain of intravenous cannulation: A randomized clinical trial. Am J Emerg Med 2017; 35: 1064-8.
• 10. Hogan ME, Smart S, Shah V, Taddio A. A systematic review of vapocoolants for reducing pain from venipuncture and venous cannulation in children and adults. J Emerg Med 2014; 47: 736–49.
• 11. Griffith VJ, H D. Vapocoolants for pain treatment during intravenous cannulation. Cochrane Database Syst Rev 2016; 4: 9484.
• 12. Persson AKM, Åkeson J. Prediction of acute postoperative pain from assessment of pain associated with venous cannulation. Pain Pract 2019; 19: 158-67.
• 13. Rüsch D, Koch T, Seel F, Eberhart L. Vapocoolant spray versus lidocaine ınfiltration for radial artery cannulation: a prospective, randomized, controlled clinical trial. J Cardiothorac Vasc Anesth 2017; 31: 77-83.
• 14. Hall LM, Ediriweera Y, Banks J, Nambiar A, Heal C. Cooling to reduce the pain associated with vaccination: A systematic review. vaccine 2020; 38: 8082-9.
• 15. Farion KJ, Splinter KL, Newhook K, Gaboury I, Splinter WM. The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial. CMAJ 2008; 179: 31-6.
• 16. Hartstein BH, Barry JD. Mitigation of pain during intravenous catheter placement using a topical skin coolant in the emergency department. Emerg Med J 2008; 25: 257.
• 17. Costello M, Ramundo M, Christopher NC, Powell KR. Ethyl vinyl chloride vapocoolant spray fails to decrease pain associated with intravenous cannulation in children. Clin Pediatr (Phila) 2006; 45: 628-32.
• 18. Su HC, Hsieh CW, Lai NM, Chou PY, Lin PH, Chen KH. Using vibrating and cold device for pain relieves in children: A systematic review and meta-analysis of randomized controlled trials. J Pediatr Nurs 2021; 61: 23-33.
• 19. Moon YE, Kim SH, Seok H, Lee SY. Comparison of the effects of vapocoolant spray and topical anesthetic cream on pain during ıntraarticular ınjection of the shoulder: a randomized double-blind controlled trial. Archives of Physical Medicine and Rehabilitation 2020; 101: 1689-95.
• 20. Page DE, Taylor McD. Vapocoolant spray vs subcutaneous lidocaine injection for reducing the pain of intravenous cannulation: a randomized, controlled, clinical trial, BJA: British Journal of Anaesthesia 2010; 4: 519–25.
• 21. Zhu Y, Peng X, Wang S, et al. Vapocoolant spray versus placebo spray/no treatment for reducing pain from intravenous cannulation: A meta-analysis of randomized controlled trials. Am J Emerg Med 2018; 36): 2085-92.
• 22. Biro P, Meier T, Cummins AS. Comparison of topical anaesthesia methods for venous cannulation in adults. Eur J Pain. 1997; 1: 37-42.
• 23. Bedel C, Korkut M, Selvi F, Zortuk O. The Bedel Score: Suggesting a New Scoring System to Avoid Negative Appendectomy. Journal Of Medical And Surgical Research. 2021;8:966-72. DOI: 10.46327/msrjg.1.000000000000198