Comparative Study of the Effectiveness of Vapocoolant Spray Versus EMLA Cream in Reducing Pain During Intravenous Cannulation in the Adult Population.

Abstract

Intravenous cannulation is a prerequisite before any major or minor surgical procedures. The rationale of the study was to compare the effectiveness of eutectic mixtures of local anesthetics (EMLA) cream and vapocoolant spray for pain reduction during intravenous (I.V.) cannulation. This observational prospective cohort study was done on 140 patients requiring I.V. cannulation prior to elective procedure who were divided into two groups, including group E: EMLA (eutectic mixtures of local anesthetics) cream and group V: Vapocoolant spray (ethyl chloride). Visual Analogue Scale (VAS) score, hemodynamic variables, and cost analysis were studied between the two groups. Statistical analyses were done using Mann-Whitney U test, unpaired t-test, Fisher's exact test, and chi-square test were used to identify variation in pain scores between the two groups. Post hoc analysis was done at different time points by the Bonferroni test. P-value < 0.05 was considered statistically significant. It was observed that the groups were comparable in terms of age, sex, and American Society of Anesthesiologists (ASA) physical status. A highly significant difference was observed between the two groups in terms of VAS scores for pain. There was also a significant difference in terms of heart rate and movement of hands during cannulation between the two groups. No changes were observed in the other hemodynamic parameters. Vapocoolant spray was also more cost-effective compared to EMLA cream with an occlusive dressing. Vapocoolant spray was a better tool compared to EMLA cream for intravenous cannulation, especially in emergency settings.