Efficacy of ethyl chloride as a local anesthetic for venipuncture and intravenous cannula insertion in a pediatric emergency department

Ramsook, Chris; Kozinetz, Claudia A.; Moro-Sutherland, Donna

doi:10.1097/00006565-200110000-00005

Cited by 42 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies of vapocoolant sprays did not show a reduction in pain due to intravenous cannulation in children. 19,20 We do not know whether changes in the product composition (refrigerant), application process, speed of evaporation or trial methodologies were responsible for our positive results.…”

Section: Discussionmentioning

confidence: 91%

“…Our cannulation attempt occurred within 60 seconds after application because vapocoolant sprays have a brief duration of action (30-60 seconds). In the other studies 19,20 the reported timing of cannulation was vague. The child life specialists in our study used standardized preparation and distraction techniques to reduce children's anxiety.…”

Section: Discussionmentioning

confidence: 98%

“…In the prior studies, 19,20 the application time of the spray was limited to 5 seconds. As recommended by the manufacturer of the spray we used, 21 we allowed up to 10 seconds to achieve skin blanching.…”

Section: Discussionmentioning

confidence: 99%

“…There is no ideal control spray for studies such as ours. In earlier trials, 19,20 isopropyl alcohol was used for the control spray, which may have had an anesthetic effect because of its rate of evaporation. The pain scores that we observed in patients who received placebo were similar to those reported in studies that used other placebos, 28 but they were markedly higher than results for a placebo group in a study involving adults.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

Farion¹,

Splinter²,

Newhook³

et al. 2008

Canadian Medical Association Journal

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Farion¹,

Splinter²,

Newhook³

et al. 2008

Canadian Medical Association Journal

View full text Add to dashboard Cite

“…Although there is a fair amount of evidence supporting the efficacy of vapocoolant for medical procedures in adults (17), results in children have been mixed. For example, a recent comparison of vapocoolant and placebo sprays for intravenous cannula insertion in children revealed no significant benefit of vapocoolant on self-reported pain (18). Alternatively, Cohen Reis and Holubkov (19) found positive effects of vapocoolant; specifically, it was as effective as topical creams.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Interventions for paediatric procedure-related pain in primary care

MacLaren

Cohen

2007

Paediatrics and Child Health

View full text Add to dashboard Cite

As a part of routine and specialized health care, children are subjected to a number of invasive medical procedures (eg, immunizations, venipunctures). These events are anxiety provoking and painful, and can have detrimental short-term and long-term effects. The present paper provides an overview of pharmacological and nonpharmacological techniques for the management of procedure-related pain in children, with a focus on clinically relevant information. Sufficient detail is provided to facilitate the translation of reviewed strategies into standard practice. ASSESSMENT AND TREATMENT OF PROCEDURAL PAIN IN CHILDREN As a part of routine and specialized health care, children are subjected to a number of invasive medical procedures (eg, immunizations and venipunctures). According to guidelines published by the United States Centers for Disease Control and Prevention in 2005, children are to receive roughly 29 intramuscular immunization injections by six years of age. These events are anxiety provoking and painful, especially for younger children, who exhibit higher distress than older children (1-3). In fact, Jacobsen et al (2) report that as many as 45% of four-to six-year-old children experience 'serious or severe distress' during immunization procedures. In many cases, procedure-related distress is so severe that it results in escape behaviour (eg, kicking) and a need for child restraint (4).In addition to the unnecessary short-term suffering, paediatric procedural distress can have long-term detrimental effects on the patient. For instance, Bijttebier and Vertommen (5) found that children with a history of negative medical experiences showed higher levels of anxiety before a venipuncture procedure, and were more distressed and less cooperative during the procedure. Childhood medical distress has also been linked to adults' reports of pain and fear regarding medical events, and negative experiences with early medical procedures have even been linked to the avoidance of future health care (6). In addition, early painful procedures have been associated with increased behavioural sensitivity to later medical insults (7), a finding that is supported by recent physiological evidence indicating that activation of the nociceptive system can alter neuropathways, resulting in increased sensitivity to later stimulation (8).Given the evidence for short-and long-term impacts of procedure-related pain, there has been a recent surge in research into factors that are associated with increased pain and the development of pain management interventions. Unfortunately, much of this research has been published in specialty psychology and anesthesiology journals and has not been widely disseminated into primary care. Hence, the purpose of the present article is to provide a brief review of research on paediatric procedural pain management and to provide specific practice recommendations. Rather than providing an exhaustive review of all interventions available

show abstract

Cost-effectiveness Analysis of Anesthetic Agents During Peripheral Intravenous Cannulation in the Pediatric Emergency Department

Pershad

Steinberg

Waters³

2008

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

show abstract

Efficacy of ethyl chloride as a local anesthetic for venipuncture and intravenous cannula insertion in a pediatric emergency department

Cited by 42 publications

References 17 publications

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

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

Interventions for paediatric procedure-related pain in primary care

Cost-effectiveness Analysis of Anesthetic Agents During Peripheral Intravenous Cannulation in the Pediatric Emergency Department

Contact Info

Product

Resources

About