Vapocoolant Spray Research Articles

Efficacy of ShotBlocker device versus vapocoolant spray for spinal needle pain relief during spinal anaesthesia in elective caesarean section - A randomised controlled trial.

Apprehension of pain due to a spinal needle is often a cause of anxiety and refusal. ShotBlocker provides non-painful physical stimulation, inhibiting pain perception. The vapocoolant spray contains ethyl chloride vapours, rapidly raising the skin temperature and hampering the transmission of noxious stimuli. The present study compared the effectiveness of the ShotBlocker device and the vapocoolant spray in reducing spinal needle-associated pain in primigravida women undergoing elective lower-segment caesarean section (LSCS). We enroled 144 primigravida women undergoing elective LSCS and were randomised to Group SB (the ShotBlocker device was firmly pressed over the skin, and the spinal needle was inserted through its slit), Group V (the vapocoolant spray was applied at the puncture site before spinal needle insertion), and Group C (received local infiltration before spinal anaesthesia (SA)). The groups were compared for needle-associated pain and patient satisfaction using a 10-point visual analogue scale (VAS) and a 3-point Likert scale. The mean (standard deviation) [95% confidence interval (CI)] VAS scores of Group SB 3.85 (0.74) [3.64, 4.07] and Group V 3.04 (0.74) [2.83, 3.26] were significantly lower than that of Group C 5.19 (0.92) [3.28, 3.62]). On the Likert scale, the maximum number of patients in the vapocoolant group (64.6%) responded satisfactorily, while in the control group, the majority (62.5%) of participants responded dissatisfied (P < 0.001). Both the ShotBlocker and vapocoolant spray reduce needle puncture-associated pain before SA in primigravida patients undergoing elective LSCS. However, the vapocoolant spray is more beneficial in reducing spinal needle-associated pain than the ShotBlocker device.

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

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.

The Effect of Vapocoolant Spray and Baby Shark Vibrator on Children’s Pain during Invasif Procedure

Invasif procedure is a procedure that is often performed on children. This procedure is related to needles that causes pain in children. Children who experienced pain during invasif procedure need treatment to avoid trauma. It is necessary to apply atraumatic care through the use of interventions that eliminate or minimize the psychological and physical distress suffered by children, one of which is the use of vibrators with music and cold compresses to minimize pain. This study aims to determine the effectiveness of giving a baby shark vibrator compare with vapoocoolant spray against pain in children undergoing invasif procedure such as injection and venipuncture. The researcher divided the respondents into 2 groups, the intervention group (baby shark vibrator) and the control group (vapocoolant spray) which are taken randomly with a total of 60 children participating in this study. The assessment of children's pain using the FLACC instrument (face, legs, activity, cry and consolability). The results of statistical tests showed that there was a no significant difference in pain in the intervention group and the control group (p=0.077). The use of a baby shark vibrator can be an alternative to reduce pain in children during invasif procedure because for some children, it is more convenient and distracting.

Temperature changes of CoolSticks during simulated use

IntroductionCold sensation is often used to check neuraxial anaesthesia and analgesia. One opportunity to reduce the carbon footprint of anaesthesia is to replace vapo-coolant sprays such as ethyl chloride with a reusable device called the CoolStick, which is cooled in a refrigerator between uses. We designed a study to investigate how long the CoolStick remains at its working temperature, which we defined as <15 °C. MethodExperiments were undertaken using a thermocouple and digital temperature sensor attached to the CoolStick. We conducted two experiments to assess temperature changes following removal from the refrigerator for 10 min; the first investigated passive re-warming in the ambient theatre environment and the second investigated re-warming in simulated use. In our third experiment, we investigated the time taken to cool the device in the refrigerator, following use. Each experiment was repeated three times. ResultsIn the passive re-warming experiment, the mean CoolStick temperature was 7.3 °C at the start, and 14.3 °C after 10 min. In the simulated use experiment, the mean CoolStick temperature was 7.3 °C at the start, and 18.9 °C at 10 min. In the cooling experiment, the mean CoolStick temperature was 15 °C at the start and 7.6 °C at 40 min. ConclusionOur study indicates that it is feasible to use the CoolStick for providing cold sensation in clinical practice. Further study would be required to directly compare the effectiveness of the device to existing methods such as coolant sprays or ice in the clinical setting.

The effect of using vapocoolant spray for pain reduction in arteriovenous fistula cannulation among patients undergoing hemodialysis: A randomized control trial

AimThe aim of this study was to assess the effects of alkane vapocoolant spray in reducing pain during arteriovenous access cannulation in adult patients undergoing hemodialysis. BackgroundDeveloping and applying various approaches for pain relief remain important responsibility for nurses. MethodsThis study was designed as an experimental study with a cross-over design. Thirty-eight patients on hemodialysis volunteered to undergo cannulation of their arteriovenous access, after the application of vapocoolant or placebo spray or no intervention. Subjective and objective pain levels were assessed, along with various physiological parameters pre- and post-cannulation. ResultsStatistically significant between-group differences were observed in subjective pain at the venous (F = 4.97, p = 0.009) and arterial (F = 6.91, p = 0.001) puncture sites. The mean arterial site subjective pain scores were 4.45 ± 1.31 (no treatment), 4.04 ± 1.82 (placebo), and 2.98 ± 1.53 (vapocoolant spray). Significant between-group differences were observed in objective pain scores during arteriovenous fistula puncture (F = 5.13, p = 0.007). The mean objective pain scores after arteriovenous fistula puncture were 3.25 ± 2.66 (no treatment), 2.17 ± 1.76 (placebo), and 1.78 ± 1.66 (vapocoolant spray). Post-hoc test results indicated vapocoolant spray application was associated with significantly lower pain scores than no treatment or placebo. Patient blood pressure and heart rate recordings did not differ among the interventions. ConclusionVapocoolant application was significantly more effective than the placebo or no treatment in reducing the pain of cannulation in adult patients undergoing hemodialysis.

Efficacy and safety of vapocoolant spray for vascular puncture in children and adults: A systematic review and meta-analysis.

The aim was to evaluate the effectiveness and safety of the vapocoolants for vascular puncture in children and adults. The search was carried out in PubMed, Web of Science, Embase and The Cochrane Library, from inception to March 2022. Randomized controlled trials comparing vapocoolants to control conditions for participants received intravenous cannulation or arterial puncture were included. Two reviewers independently performed selection of studies, data extraction, and assessment of risk of bias. The analysis was performed using fixed or random-effects model with mean differences or standardized mean difference and risk ratios. A total of 25 studies involving 3143 participants were included. Compared with control conditions, vapocoolants may not decrease the pain of patients with arterial puncture (SMD = -0.36, 95% CI = -0.92 to -0.19, P = 0.20), but may more effectively relieve pain for adults received vein puncture (SMD = -0.65, 95% CI = -0.85 to -0.45, P < 0.00001). The application of vapocoolant increased the procedural difficulty of medical personnel (RR = 2.49, 95% CI = 1.62 to 3.84, P<0.000 1) and participants were more willing to use the spray in the future (RR = 1.88, 95% CI = 1.34 to 2.64, P = 0.0002). There was no significant difference for the first attempt success rate of the procedure and the occurrence of adverse events. Vapocoolant spray may relieve pain in adults received vein puncture and cannot cause severe side effects, but is ineffective in children. It also had no effect on patients with arterial puncture. In addition, the application of spray increases procedural difficulties for medical professionals, but does not decrease first attempt success rate, and many patients would like to use the spray again for pain relief in the future. Thus, more rigorous and large-scale studies are needed to determine its effectiveness in vascular access.

Comparison of Three Anaesthetic Options to Reduce Acute Pain Response in Kid Goats

ABSTRACT Three options for anesthetizing the skin around the horn bud of dairy goat kids were explored. Forty-five <10-day-old Saanen goat kids from were randomly split into five treatment groups (topical anesthetic cream (TA), vapocoolant spray (VS), local anesthetic applied by jet injector (JI), control – no treatment but painful stimulus applied (C), sham – no treatment and touching sites with a finger. The painful stimulus was multiple needle pricks on the skin around the horn bud. The outcome variables measured were heart rate movement, and vocalization during treatment application and administration of a painful stimulus around the horn bud. Heart rates were greater during application of a VS compared to TA.Neither the TA nor the VS appeared to have any effect on the response to the painful stimulus. Kids in the JI group had a 96% reduced odds of expressing a marked pain response in comparison to TA group and an 83% reduction in the odds of a high movement grade during a painful procedure in comparison to the combined results of the other three treatment groups.

Vapocoolant Spray for Pain Control in Intramuscular Injection Applications: A Prospective, Randomized Controlled Trial

Abstract Background Many pharmacological and nonpharmacological methods have been investigated along with advances in pain treatment. One of these nonpharmacological methods is the use of vapocoolant spray. Objective This study aimedto demonstrate the effectiveness of vapocoolant spray to reduce pain during intramuscular (IM) injection. Patients and Methods The study included ≥18 years old patients admitted to the emergency department who were asked to undergo IM injection. Patients were randomly divided into two groups as vapocoolant spray and control group. Demographic data, injection side, and visual analog scale (VAS) of the patients were recorded. Results Mean VAS values during IM injection were significantly lower in patients treated with vapocoolant spray compared with the control group. The severity of pain during IM injection was lower in the vapocoolant spray group as both moderate pain (VAS &gt; 3 cm) and severe pain (VAS &gt; 5.4 cm) compared with the control group. Conclusion Vapocoolant spray to be applied before IM injection is effective in reducing pain caused by the injection.

The efficacy of vapocoolant spray for the improved tolerance of catheter pain in emergency patients.

This study aimed to determine if dogs and cats presenting as an emergency had improved tolerance of intravenous catheterisation following the application of vapocoolant spray when compared to a saline control. A randomised controlled trial of client-owned dogs and cats presenting as an emergency and requiring intravenous catheterisation was performed. Patient signalment and mentation score were recorded. All animals were restrained and had their fur clipped over the catheterisation site. They were then randomly allocated to either have a swab saturated with vapocoolant spray (treatment) or a swab saturated with saline (control) applied to the clipped area before intravenous catheterisation. The procedure was video recorded and a single blinded observer reviewed the recordings and assigned reaction scores (0 to 3) at four time points (initial restraint, limb handling, swab application and skin puncture). Between October 2020 and January 2021, a total of 100 patients (79 dogs, 21 cats) were enrolled, with 50 in each group. No significant difference in species, age, breed, sex or mentation score was detected between the two groups. There was no significant difference in reaction scores between the groups at any time point with the exception of a significantly increased swab application reaction score in the treatment group compared to the control group. The indirect application of vapocoolant spray via a swab before catheterisation does not significantly reduce the reaction of dogs and cats to intravenous catheterisation in an emergency setting.

Comparison of music and vapocoolant spray in reducing the pain of venous cannulation in children age 6-12: a randomized clinical trial

BackgroundVenous cannulation is among the most stressful and painful experiences of children hospitalization. Children with thalassemia need regular blood transfusion which needs venous access each time. The quality of care and quality of life of children will be improved if appropriate methods are used to reduce pain. This study aimed to compare vapocoolant spray and music in the reduction of pain of Venous cannulation in children with thalassemia.MethodsThe study was a randomized controlled clinical trial with a cross-over design. Thirty-six children with thalassemia from Thalassemia Patients of Pasteur Hospital in Bam from October to December 2020 and were recruited and randomly allocated to two arms. The pain of venous cannulation (no treatment) was measured in the first blood transfusion session as control. In the second and third sessions, two arms received music and vapocoolant spray before the venous cannulation with a cross-over design. The intensity of pain was measured by a Visual Analogue Scale (VAS). The change in pain scores was tested by ANOVA and Tukey post-hoc test between three measurements.ResultsDuring and after the cannulation, the pain was significantly lower in the vapocoolant measurement than in control and music (p < 0.05). There was a significant effect of vapocoolant spray during the procedure F (2, 90) = 25.604, p = 0.001. Also, there was a significant effect of vapocoolant spray after the procedure F (2, 90) = 10.087, p = 0.004). Music did not reduce the pain during cannulation (p = 0.413) and after that (p = 0.807) significantly when compared with control.ConclusionsVapocoolant was an effective method of pain reduction in the reduction of venous cannulation pain. Music was not effective in the reduction of venous cannulation pain when we compared it with controls. The pain of venous cannulation is rated as high and it can have negative effects on the children. There is a need to do more research on the methods of pain reduction of venous cannulation.Trial registrationThe trial is registered: IRCT20111019007844N13, 13/03/2020. Available at: https://en.irct.ir/trial/42904.

Sterile water injections for relief of labour pain (the SATURN trial): study protocol for a randomised controlled trial

BackgroundUp to 80% of women use some form of pharmacological analgesia during labour and birth. The side effects of pharmacological agents are often incompatible with the concurrent use of non-pharmacological pain relieving strategies, such as water immersion, ambulation and upright positioning, or may have negative effects on both the mother and fetus. Sterile water injections given into the skin of the lumbar region have been demonstrated to reduce back pain during labour. However, the injections given for back pain have no effect on abdominal contraction pain. The analgesic efficacy of sterile water injections for abdominal pain during childbirth is unknown. The injections cause an immediate, brief but significant pain that deters some women from using the procedure. This study aims to investigate the use of water injections given intradermally into the abdomen to relieve labour contraction pain. A vapocoolant spray will be applied to the skin immediately prior to the injections to reduce the injection pain.MethodsIn this pragmatic, placebo controlled trial 154 low-risk women in labour at term with a labour pain score ≥ 60 on a 100 millimitre visual analogue scale (VAS) will be randomly allocated to receive either six injections of sterile water or a sodium chloride 0.9% solution as a placebo (0.1–.0.3 ml per injection). Three injections are given along the midline from the fundus to the supra-pubis and three laterally across the supra-pubis. The primary outcome will be the difference in VAS score 30 min post injection between groups. Secondary outcomes include VAS score of the injection pain on administration, VAS score of labour pain at 60 and 90 min, maternal and neonatal birth outcomes.DiscussionAccess to effective pain relief during labour is fundamental to respectful and safe maternity care. Pharmacological analgesics should support rather than limit other non-pharmacological strategies. Sterile water injections have the potential to provide an alternative form of labour pain relief that is easy to administer in any labour and birth setting, and compatible with other non-pharmacological choices.Trial registrationANZCTR (ACTRN12621001036808) Date submitted: 22/06/2021. Date registered: 05/08/2021. https://www.anzctr.org.au/

Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial.

The digital nerve block is an effective method of anesthesia before minor surgical interventions on the fingers. However, patients may experience a lot of pain and anxiety during this procedure. The efficacy of topical vapocoolant spray during minor procedures has been demonstrated in previous studies. we aimed to evaluate the effectiveness of topical vapocoolant spray in reducing pain during digital nerve block. This prospective, randomized clinical study was conducted to evaluate the effectiveness of vapocoolant spray application in reducing pain during digital block. The patients were categorized into 2 groups as spray-treated and control group. A routine digital block process was applied to the control group. Spray application was performed in two groups of 50 each, in a manner of bilateral and unilateral to the finger. Demographic data of the patients, such as gender, age, dominant hand, injury patterns, injection site and injury sites, were recorded. After the application, the patients' visual analog scale (VAS) was evaluated. Of the participants, 100 were randomly assigned to the vapocoolant spray-treated group, and 50 were included in the control group. The VAS pain score during penetration in both spray groups was significantly lower than the control group (p < 0.001). Pain change during penetration was found to be significantly lower in the bilateral spray-treated group compared to the control group (p < 0.001). Pain change during infiltration was significantly lower in both spray groups compared to the control group (p < 0.001). Spray application prior to digital nerve blocking can be used to reduce needle penetration pain associated with this procedure and pain associated with local anesthetic infiltration.

Effectiveness of Vapocoolant Spray on Venipuncture Pain in Young Male Donors: A Randomized Controlled Trial.

The aim of this single-blinded, randomized controlled study was to determine the effectiveness of vapocoolant spray in reducing pain related to venipuncture in young, healthy male blood donors. The participants were separated into 2 groups by randomization. The donors in the control group (n = 44) were not given any intervention during the blood collection process. Vapocoolant spray was applied to the donors in the vapocoolant spray group (n = 44). The pain score was 1.90 ± 1.47 for the vapocoolant spray group and 3.23 ± 2.21 for the control group, and the difference between the groups was found to be statistically significant (P = .02). The study result showed that the use of vapocoolant spray for pain management is an effective method of reducing pain related to venipuncture during the process of blood donation in young male donors.

İntravenöz Kanülasyon Ağrısı İçin Vapocoolant Sprey: Prospektif, Randomize Kontrollü Bir Çalışma

Introduction: Peripheral intravenous (IV) cannulation are routine procedures in emergency department (ED) admissions. Vapocoolant sprays have a potential advantage over other topical agents.We aimed to see how effective vapocoolant spray was in reducing pain during intravenous cannulation versus a control group in this study. Materials and Methods: This is a prospective, randomized control study consisting of patients who were admitted to the ED. The study included patients aged 18 and over who applied to the ED and had IV cannulation. The patients were divided into 2 groups as control and vapocoolant spray groups. Age, gender, and dominant hand status of all patient groups were recorded. Side effects were observed after the application. The Visual Analogue Scale (VAS), which is the most widely used scale to measure pain, was used. Results: 206 individuals were randomized. The mean age of the vapocoolant spray group was 46.40±16.44 years, while it was 46.75±17.49 years for the control group. The vapocoolant spray group was found to have significantly lower mean VAS values during IV cannulation than the control group (1.47±1.32 vs. 3.97±1.97 p&amp;lt;0.001). It was found that the vapocoolant spray-applied group had a significantly lower percentage in terms of moderate pain (VAS&amp;gt;3 cm) compared to the control group (7.8% vs 58.3%, p&amp;lt;0.001). Besides, the percentage of severe pain (VAS&amp;gt;5.4 cm) in the spray-applied group was found to be significantly lower than the control group (1% vs. 20.4%, p&amp;lt;0.001). Conclusion: The vapocoolant spray can be used effectively to mitigate the pain associated with the pre-IV cannulation procedure and can be an alternative method for reducing pain in emergency departments.

Effectiveness of ischemic compression pressure versus spray and stretch technique in the management of active myofascial trigger points of trapezius muscle.

Background: Now, a days myofascial trigger points are tremendously occurring and become a stressful part of nearly any person at any time in a lifetime. This study compares the effects of ischemic compression pressure with spray and stretch technique to treat active myofascial trigger points of the trapezius muscle in patients with neck pain.&#x0D; Methodology: A comparative interventional study was conducted at Dow University of Health Sciences from December 2016 and May 2017. Seventy patients (35 in each group) with active myofascial trigger points of trapezius were randomly assigned to group A (ischemic compression pressure) and group B (vapocoolant spray and stretch technique). Baseline and last session assessment of pain intensity, pain pressure tolerance, cervical range of motion and functional disability were measured through numerical pain-rating scale, algometer, goniometer and neck disability index, respectively.&#x0D; Results: Both groups showed significant improvement in all dependent variables of study which were neck pain, cervical range of motion and pain pressure tolerance (p-value&lt;0.05). Group A showed greater improvement in pain intensity (p-value 0.015), pressure pain threshold (p-value 0.000) and cervical range of motion flexion, left side flexion and right-side flexion (p-value 0.002, 0.000 &amp; 0.004) than group B.&#x0D; Conclusion: Both ischemic compression pressure &amp; spray and stretch technique deactivated trigger points of upper fibers trapezius muscle in patients with neck pain, but the ischemic compression pressure was superior to the spray and stretch technique.

Pain associated with arteriovenous fistula cannulation: Still a problem

ContextPuncture-related pain during arteriovenous fistula cannulation is a crucial influential factor in the quality of life of chronic hemodialysis patients. Objectives/methodsIn this prospective single center study, we used a questionnaire to evaluate the patterns of pain of arteriovenous fistula cannulation in a group of hemodialysis patients. ResultsFrom a total of 123 eligible patients with arteriovenous fistula invited to participate, 83 (58 M/25 F) (median age 58 y.o.) returned questionnaires. Sixty-five benefitted from an analgesic intervention on cannulation, and 62 found this intervention effective. We evaluated the pain intensity with the échelle visuelle analogique score, the equivalent of Visual Analogue Scale score in French. No specific analgesic intervention (lidocaine patch or cream, vapocoolant spray) was more effective than the others (pNS). 30/65 patients with and 10/18 patients without analgesic intervention reported pain on cannulation (échelle visuelle analogique>1) (pNS). 21/65 patients with and 6/18 patients without analgesic intervention reported pain on needle retraction (pNS). Forty of the 65 patients with analgesic intervention and 11/18 patients without intervention feel stressed before each cannulation. The stress of arteriovenous fistula-related pain is significantly associated with a sensation of pain on cannulation (P=0.047) and needle retraction (P=0.002). ConclusionDespite prophylactic measures for arteriovenous fistula cannulation pain, patients frequently experience stress and unpleasant sensations associated with the procedure.

An Evaluation of High Preprocedural Anxiety and Venipuncture Pain Experienced by Young Children.

The aim of this study was to determine if young children with high preprocedural anxiety experience increased pain at venipuncture. This was secondary analysis of prospectively obtained data from a randomized controlled trial comparing vapocoolant spray with jet-injected lidocaine for venipuncture pain. Children aged 1 to 6 years were enrolled and videotaped. Videos were reviewed and scored for anxiety using the modified Yale Preoperative Anxiety Scale score for preprocedural anxiety (score range, 23-100). High anxiety was defined as greater than 40. Pain at the time of venipuncture was scored using the Face, Legs, Activity, Cry, and Consolability scale (score range 0-10). Moderate to severe pain was defined as greater than 3. Logistic regression assessed patient factors associated with high preprocedural anxiety and evaluated the relationship between preprocedural anxiety and pain during venipuncture. Two hundred five patients were enrolled; 59.5% of patients were male, and 53.7% were White. Mean age was 3.2 years. Prior to the procedure, 67% of patients had high anxiety. Patient age, race, sex, and previous venipuncture were not associated with increased odds of high anxiety. Moderate to severe pain at venipuncture was observed in 65% of children. High preprocedural anxiety was associated with increased odds of moderate to severe pain at venipuncture when controlled for patient characteristics (adjusted odds ratio, 4.62; 95% confidence interval, 2.03-8.54). Most young children undergoing venipuncture experienced high preprocedural anxiety. Children with high preprocedural anxiety had increased odds of moderate to severe pain at venipuncture. Anxiety-reducing interventions should be explored to reduce pain experienced during venipuncture.

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

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. 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. 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. 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. Therapeutic, Level I.

Antinociceptive effect of vapocoolant medium stream spray on hotplate latency in rat pups.

Heel sticks account for most blood tests performed in neonates without analgesia because topical local anesthetics are ineffective on heel glabrous skin. We investigated the antinociceptive effect of an alternative topical analgesic, a vapocoolant spray, on hind paw glabrous skin of rat pups. The spray was applied by two methods: method 1 for 4s at a distance of 8cm and method 2 for 10s at a distance of 18cm. The rat pups were randomized to either method 1 (n=32) or method 2 (n=31). Vapocoolant spray was applied to one hind paw randomly, and saline spray was applied to the contralateral paw. The paws were exposed to a hotplate test to measure withdrawal latency time before and 30s after the spray applications. Additionally, rat pups were tested for tissue toxicity in method 1 (n=20) and method 2 (n=20) after application of the vapocoolant spray before heel sticks three times a day for two consecutive days. Analyses of spray and method effects on hotplate withdrawal latency time were determined by nonparametric Wilcoxon tests to assess paired difference between vapocoolant spray and saline spray and to compare difference in medians between the two methods. Method 1 and method 2 vapocoolant spray applications significantly prolonged the withdrawal latency time compared with saline, a median difference of 0.6s (IQR 0.1-1.2) for method 1 and 9.5s (IQR 5.5-10.7) for method 2 (a 15-fold longer latency time with method 2). Method-2 produced significantly longer withdrawal latency time than method 1 with a difference in median time of 8.9s (CI: 95% 7.3-10.4s, P<.0001). No histopathological changes were detected. Compared with method- 1, the vapocoolant spray in method 2 produced significantly longer withdrawal latency time that is clinically applicable to collecting blood samples after a heel stick.

83 Evaluation of transmammary-delivered firocoxib and an ethyl chloride spray to mitigate pain associated with processing procedures in piglets

Abstract Piglets raised in commercial production systems in the U.S. undergo painful management procedures, including surgical castration, tail docking and ear notching, without analgesia or anesthesia provision for pain relief. This is a significant animal welfare concern. There is an immediate need to identify the most practical and effective analgesia or anesthesia option for use on-farm. The objective of this study was to assess the efficacy of 2.0mg/kg firocoxib, administered to the sow and delivered transmammary to her piglets, and a vapocoolant spray (ethyl chloride) to reduce processing pain. Five-day old male and female Yorkshire-cross piglets were used. 2.0mg/kg firocoxib was administered to the sow intramuscularly 7h prior to processing piglets. An ethyl chloride spray was applied to the ears, tail and scrotum of the piglets immediately before ear notching, tail docking and surgical castration, respectively. Piglets were assigned to one of four treatment groups: firocoxib and vapocoolant spray (FV; n=32), firocoxib only (F; n=32), vapocoolant spray only (V; n=32), no treatment (CON; n=32). The observation period was from 24h pre- to 48h post-processing (specific time points = baseline, 0h, 1h, 2h, 4h, 7h, 24h, 30h, 36h, 48h). Preliminary results found piglets displayed significantly more pain-related behaviors at 24h and 30h post-processing than at most other time points (p&amp;lt; 0.05). Piglets had significantly higher cranial temperatures at 7h post-processing than all other time points (p&amp;lt; 0.05). There was a trend in FV and F piglets having a higher cranial temperature at 36h post-processing compared to V and CON piglets (p=0.08). All piglets had significantly higher hair cortisol levels at 4 vs 20-days old (p&amp;lt; .0001); however, there were no significant treatment effects on cranial temperature, hair cortisol or pain behavior, suggesting firocoxib and the ethyl chloride spray were unable to significantly reduce piglet pain post-processing. Further study analysis is needed to confirm these initial findings.