title: Use of ethyl chloride topical anesthetic to reduce procedural pain in pediatric oncology patients.
abstract: Pediatric cancer patients often become anxious, agitated, combative, and uncooperative due to the pain or fear of pain during invasive procedures. Generally, it is not the actual administration of medicines that produces this reaction, but the fear of the needle stick itself. Increased education and implementation of coping mechanisms is often not enough to allay this fear. The tangible solution of using ethyl chloride, an anesthetic spray, before port sticks, lumbar punctures, and bone marrow aspirations, was instituted by the hematology-oncology clinic to determine if the pain, emotional trauma, and fear of cancer treatments could be reduced in oncology patients. Survey results on 60 patients and 60 parents/caretakers showed that when given the choice to use the spray or to refuse its use, 68% of the parents thought that the patient had more of a sense of control and, thus, involvement in their treatment. Seventy-eight percent of the patients reported experiencing less pain associated with procedures. Staff noted an increase in cooperation, less combativeness, and more compliance with treatment. Perceiving the child's discomfort diminished, 87% of the parents/caretakers report feeling less anxious and, therefore, more capable of being supportive to each other and their child. These results verified the staff's perceptions of the advantages of using this noninvasive anesthetic. Ethyl chloride is an easy, effective, concrete approach to reducing procedural pain in pediatric oncology patients.
authors.affiliation: Hematology-Oncology Outpatient Department, Cook-Fort Worth Children's Medical Center, Texas 76104.
authors.forename: S C
authors.initials: SC
authors.lastname: Zappa
authors.forename: S B
authors.initials: SB
authors.lastname: Nabors
mesh_terms: D000287:Administration, Topical; D017028:Caregivers / Q000523:psychology; D002648:Child; D005018:Ethyl Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D006801:Humans; D009369:Neoplasms / Q000451:nursing / Q000628:therapy*; D009741:Nursing Staff, Hospital / Q000523:psychology; D009859:Oncology Nursing / Q000592:standards; D010146:Pain / Q000188:drug therapy* / Q000451:nursing; D010371:Pediatric Nursing / Q000592:standards
chemical_list: D005018:Ethyl Chloride