Reducing Pain During Emergency Arterial Sampling Using Three Anesthetic Methods: A Randomized Controlled Clinical...

Area of Science:

• Emergency Medicine
• Pain Management
• Anesthesiology

Background:

• Arterial blood sampling, particularly radial artery puncture, is frequently associated with considerable patient discomfort.
• Effective pain management strategies are crucial for improving patient experience during diagnostic procedures in the emergency department.

Purpose of the Study:

• To evaluate and compare the efficacy of three anesthetic interventions—anesthetic cream, cryoanalgesia, and subcutaneous mepivacaine—against standard practice (no anesthesia).
• To determine the most effective method for mitigating pain during radial artery puncture for arterial blood gas analysis in emergency department patients.

Main Methods:

• A randomized controlled trial design was employed to assess the comparative effectiveness of the anesthetic methods.
• Participants undergoing radial artery puncture for arterial blood gas tests in the emergency department were randomized into four groups: anesthetic cream, cryoanalgesia, subcutaneous mepivacaine, or no anesthesia (control).

Main Results:

• Subcutaneous mepivacaine yielded the lowest median pain score (1 IQR 0.6-1.3), while the control group reported the highest (5 IQR 4.0-7.0).
• Both mepivacaine (p=0.023) and cryoanalgesia (p=0.012) demonstrated statistically significant reductions in pain compared to the control group.
• Anesthetic cream did not show a significant difference in pain reduction compared to the control group (p=0.861).

Conclusions:

• The findings support the implementation of anesthetic techniques such as cryoanalgesia or mepivacaine to manage and reduce pain associated with arterial puncture.
• These methods offer a viable solution for improving patient comfort during essential diagnostic procedures in emergency settings.