Analgesic pretreatment for antibiotic skin test: vapocoolant spray vs ice cube.
OBJECTIVE
The objective of this study was to compare the efficacy of ethyl chloride spray and ice cube for the control of pain induced by the antibiotic skin test.


METHODS
We performed a prospective, crossover, randomized study in which healthy adult volunteers received an intradermal skin test on both arms after different analgesic pretreatments. We assessed the pretreatment pain and discomfort after the intradermal skin injection using a 100-mm visual analogue scale.


RESULTS
A total of 50 volunteers were enrolled in the study. The mean pain scores after the skin test were 32.4 +/- 17.6 and 54.7 +/- 22.4 mm, for the ice cube and vapocoolant spray pretreatment, respectively (P < .0001). The mean discomfort scores during pretreatment were 20.0 +/- 15.2 mm for ice cube and 10.5 +/- 11.5 mm for vapocoolant spray (P < .0001). Forty-five (90%) subjects preferred the ice cube pretreatment for the intradermal skin test.


CONCLUSIONS
The ice cube application was significantly more effective than the vapocoolant spray in reducing the pain of the antibiotic skin test. Hence, the ice cube pretreatment is suggested for easy and fast pain reduction for the antibiotic skin test in the emergency department.
Yoon
Woo Yong
WY
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
Chung
Sung Pil
SP
Lee
Hahn Shick
HS
Park
Yoo Seok
YS
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D050785:Cryoanesthesia / Q000379:methods*; D004636:Emergency Service, Hospital; D005018:Ethyl Chloride / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007053:Ice; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D012881:Skin Temperature
D000779:Anesthetics, Local; D007053:Ice; D005018:Ethyl Chloride