Cryotherapeutic topical analgesics for pediatric intravenous catheter placement: ice versus vapocoolant spray

Area of Science:

• Pediatric Emergency Medicine
• Pain Management
• Cryotherapy

Background:

• Intravenous catheter placement is a common cause of pain for hospitalized children.
• Effective pain relief methods are crucial for pediatric patient comfort and procedural success.

Purpose of the Study:

• To compare the efficacy of vapocoolant spray versus topical ice packs for pain reduction during intravenous catheter insertion in pediatric patients.
• To assess patient satisfaction with each cryotherapeutic method.

Main Methods:

• A prospective study enrolled 95 pediatric patients (aged 9-18 years) requiring IV catheter placement.
• Participants were randomized to receive either vapocoolant spray or a topical ice pack for 3 minutes prior to IV insertion.
• Pain levels were assessed using Visual Analog Scale (VAS) scores at baseline, post-treatment, and during IV insertion, with physician assessments also recorded.

Main Results:

• While median VAS scores were similar, the change in VAS from baseline was greater with vapocoolant spray, suggesting higher efficacy.
• A higher percentage of patients in the vapocoolant spray group (76%) reported their treatment worked well compared to the ice pack group (49%).
• Physician-assessed pain scores were lower and less variable than patient-reported scores. Successful IV insertion rates were high (83%) for both groups.

Conclusions:

• Vapocoolant spray appears to be a more effective analgesic than ice packs for pediatric IV insertion.
• Patient satisfaction was higher with vapocoolant spray.
• Neither cryotherapeutic method negatively impacted the success rate of IV catheter placement.