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In this issue’s column, we contemplate pain management from some alternative sources.
VAPOCOOLANT SPRAY FOR PROCEDURES: SO QUICK AND YET NOT SO EFFECTIVE
Summary
This high-quality systematic review and meta-analysis of the effectiveness of vapocoolant spray in reducing pain related to venipuncture and venous cannulation identified 12 studies including 1266 patients (509 children). Using a pooled random-effects model, the authors showed no difference in mean pain scores for vapocoolant sprays compared with placebo or with no treatment among children. In adults, spray was superior to no treatment in reducing pain, but there was no difference between spray and placebo.
Relevance
Procedural pain, especially with venipuncture and venous cannulation, is a common experience for hospitalized children. Pain, trauma, and anxiety related to such events predict future anxiety for other procedures, overall pain intolerance, and even medical traumatic stress. One easy remedy is the use of vapocoolant spray. It takes little training to use and is widely available and inexpensive, but as this study suggests, it is ineffective.
Takeaway
There is no silver bullet for reducing procedural pain. Instead, multimodal techniques including planning …
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