Comparisons of ice packs, hot water immersion, and analgesia injection for the treatment of centipede envenomations in Taiwan.
OBJECTIVE
To compare the effectiveness of ice packs and hot water immersion for the treatment of centipede envenomations.


METHODS
Sixty patients envenomated by centipedes were randomized into three groups and were treated with ice packs, hot water immersion, or analgesia injection. The visual analog score (VAS) for pain was measured before the treatment and 15 min afterward. Demographic data and data on local and systemic effects after centipede bites were collected. The VAS scores and the pain decrease (DeltaVAS) were compared between the three groups.


RESULTS
All patients suffered from pain at the affected sites; other local effects included redness (n = 49, 81.7%), swelling (n = 32, 53.3%), heat (n = 14, 23.3%), itchiness (n = 5, 8.3), and bullae formation (n = 3, 5.0%). Rare systemic effects were reported. All three groups had similar VAS scores before and after treatment. They also had similar effectiveness in reducing pain caused by centipedes bites (DeltaVAS = 2.55 +/- 1.88, 2.33 +/- 1.78, and 1.55 +/- 1.68, with ice packs, analgesia, and hot water immersion, respectively, p = 0.165).


CONCLUSIONS
Ice packs, hot water immersion, and analgesics all improved the pain from centipede envenomation. Ice pack treatment is a safe, inexpensive, and non-invasive method for pre-hospital management in patients with centipede envenomation.
Chaou
Chung-Hsien
CH
Department of Emergency Medicine, Chang-Gung Memorial Hospital, Kuei-Shang County, Taoyuan, Taiwan, Republic of China.
Chen
Chian-Kuang
CK
Chen
Jih-Chang
JC
Chiu
Te-Fa
TF
Lin
Chih-Chuan
CC
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000818:Animals; D001180:Arthropod Venoms / Q000506:poisoning*; D001181:Arthropods; D003080:Cold Temperature; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D007273:Injections, Intramuscular; D007299:Insect Bites and Stings / Q000503:physiopathology / Q000628:therapy*; D020910:Ketorolac / Q000008:administration & dosage; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D001180:Arthropod Venoms; D008614:Meperidine; D020910:Ketorolac