Advertisement
ADVANCED SEARCH

This Article Figures Only Full Text Full Text (PDF) Résumé Submit a response View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Farion, K. J. Articles by Splinter, W. M. PubMed PubMed Citation Articles by Farion, K. J., MD Articles by Splinter, W. M., MD Related Collections Other emergency medicine Children Pain Related Articles

The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial

From the Departments of Pediatrics (Farion), Emergency Medicine (Farion) and Anesthesiology (K.L. Splinter, W.M. Splinter), University of Ottawa; the Emergency Department (Newhook), Children's Hospital of Eastern Ontario; and the Children's Hospital of Eastern Ontario Research Institute (Gaboury), Ottawa, Ont

Correspondence to: Dr. William M. Splinter, Department of Anesthesiology, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa ON K1H 8L1; fax 613 738-4815; splinter{at}cheo.on.ca

Background: Established noninvasive pharmacologic means of alleviating pain and anxiety in children undergoing intravenous cannulation are time-consuming, and thus impractical for routine use in the emergency department. Vapocoolant sprays provide transient skin anesthesia within seconds of application. We compared the effect of a new vapocoolant spray to placebo on pain due to intravenous cannulation in children.

Methods: In this double-blind randomized controlled trial, which we conducted between June 1 and Sept. 12, 2006, 80 children aged 6–12 years received either vapocoolant spray or placebo before cannulation. Children rated their pain using a 100-mm colour visual analogue scale. Secondary outcomes included success rate on first attempt at cannulation and pain ratings by the children's parents, nurses and child life specialists.

Results: We found a modest but significant reduction in pain with the use of vapocoolant spray (mean difference 19 mm, 95% confidence interval [CI] 6–32 mm; p < 0.01). Cannulation on first attempt was more often successful with the use of vapocoolant spray (85.0%) than with placebo (62.5%) (mean difference 22.5%, 95% CI 3.2%–39.9%; p = 0.03). The number needed to treat to prevent 1 cannulation failure was 5 (95% CI 3–32). Parents (p = 0.04), nurses (p = 0.01) and child life specialists (p < 0.01) considered the children's pain to be reduced with the use of vapocoolant spray.

Interpretation: The vapocoolant spray in our study quickly and effectively reduced pain due to intravenous cannulation in children and improved the success rate of cannulation. It is an important option to reduce childhood procedural pain in emergency situations, especially when time precludes traditional interventions.

(http://ClinicalTrials.gov trial register no. NCT00130650.)

This article has been cited by other articles:

				C. Kemp Spray reduces pain of IV cannulation in children AAP News, October 1, 2008; 29(10): 2 - 2. [Full Text] [PDF]

				K.J.S. Anand MBBS DPhil Analgesia for skin-breaking procedures in newborns and children: What works best? Can. Med. Assoc. J., July 1, 2008; 179(1): 11 - 12. [Full Text] [PDF]

eLetters:

HOME	CURRENT ISSUE	PAST ISSUES	COLLECTIONS	HELP	SEARCH
Copyright 1995-2008, Canadian Medical Association. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p) All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.