Effects of Topical Alkane Vapocoolant Spray on Pain Intensity Prior to Digital Nerve Block for Ingrown Nail Surgery

Köse, Özkan; Saylan, Sedat; Ediz, Naim; Yigit, Seyhmus

doi:10.1177/1938640010363172

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…A study by Kose and colleagues reported a similar finding when topical alkaline vapocoolant spray’s effectiveness was evaluated. While the spray was found to relieve pain during initial skin penetration, VAS scores during injection of solution were not significantly decreased [ 21 ]. These studies suggest that the topical agents are not effective in relieving pain that is originated from the infiltration of the anesthetic agents.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

Kim

Day

Aspang

2021

IJERPH

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Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

Kim

Day

Aspang

2021

IJERPH

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“…Extended waiting time can allow a patient to brood on upcoming surgery and may also exacerbate the feeling of anxiety. 1,4,13 Needle penetration and anesthetic infiltration were reported as the 2 painful steps that cause stress and anxiety in patients undergoing nail surgery. 13 Past experience with severely painful nail trauma such as trapping in a door or crushing with a hammer, leading the patient to associate the nail site with extreme pain, may also increase the anxiety and fear of nail surgery.…”

Section: Discussionmentioning

confidence: 99%

Anxiety Among Patients Undergoing Nail Surgery and Skin Punch Biopsy

et al. 2015

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“…Franko and Stern 13 prospectively defined a change in 2 points on a Likert pain scale as clinically meaningful, however the average pain reported by participants was approximately 3 in both groups. The pain scores reported by Kose et al 28 during injection were similarly low at 2.43 and 1.32 in the control and intervention groups, respectively. The NPWT dressing changes represented in this study report higher pain scores with and without intervention, providing greater opportunity to appreciate benefit in pain reduction.…”

Section: Discussionmentioning

confidence: 67%

Does The Use of Ethyl Chloride Improve Patient-Reported Pain Scores With Negative Pressure Wound Therapy Dressing Changes? A Prospective, Randomized Controlled Trial

Tank¹,

Georgiadis²,

Bair³

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:Negative pressure wound therapy (NPWT) is commonly used for surgical incisions and large wounds, particularly in the context of trauma. Research has shown that patients report that the most painful aspect of NPWT is related to foam dressing changes. This study aimed to determine whether topical use of the vapocoolant anesthetic ethyl chloride would impact patient-reported pain during these procedures. METHODS:This study was a single-blinded, placebo-controlled randomized trial in patients who were undergoing NPWT foam dressing change following surgery performed by the orthopedic trauma team. A total of 100 patients were randomized to receive ethyl chloride topical anesthetic spray or placebo (tissue culture grade water) during dressing change. The outcome measure specified prior to enrollment was a mean decrease in patient-reported pain of 1.7 points using a numeric rating scale. Baseline and procedural characteristics were collected to investigate contributions to patient-reported pain. We hypothesized that the use of ethyl chloride would decrease patient reported pain scores. RESULTS:Significantly more females were randomized to the receive vapocoolant; remaining baseline and procedural characteristics were similar between groups. The median time for NPWT drape removal was 2.0 minutes in both groups (p = 0.66). The postprocedural pain reported by patients was significantly lower in the experimental group compared with placebo (median, 5.0 vs. 7.0; p = 0.03). Multivariate analysis adjusting for potential confounders showed treatment group to be the strongest predictor of postprocedure pain (p = 0.002). Additionally, a generalized linear model suggests that treatment group was the strongest predictor of change in pain score as reported by patients prior to and immediately following dressing change. CONCLUSIONS:Use of vapocoolant spray during NPWT dressing change for orthopedic trauma wounds and surgical incisions was feasible and resulted in significant reduction in patient-reported pain associated with the procedure.

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Effects of Topical Alkane Vapocoolant Spray on Pain Intensity Prior to Digital Nerve Block for Ingrown Nail Surgery

Cited by 8 publications

References 18 publications

Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

Anxiety Among Patients Undergoing Nail Surgery and Skin Punch Biopsy

Does The Use of Ethyl Chloride Improve Patient-Reported Pain Scores With Negative Pressure Wound Therapy Dressing Changes? A Prospective, Randomized Controlled Trial

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