title: Comparison of the effects of vapocoolant spray and topical anesthetic cream on pain during needle electromyography in the medial gastrocnemius.
abstract: OBJECTIVE
  To compare the effects of a vapocoolant spray and an eutectic mixture of local anesthetics (EMLA) cream in reducing pain during needle electromyography examination.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Physical medicine and rehabilitation department of a university hospital.
  
  
  METHODS
  Adults who underwent needle electromyography (N=99) were randomized to 1 of 2 experimental groups or the control group. Two patients dropped out during the study.
  
  
  METHODS
  In the experimental groups, vapocoolant spray or EMLA cream were applied before needle electromyography. In the control group, needle electromyography was performed without pretreatment.
  
  
  METHODS
  Intensity of pain associated with needle electromyography was assessed using a 100-mm visual analog scale (VAS). Patient satisfaction and preference for repeated use were measured using a 5-point Likert scale.
  
  
  RESULTS
  VAS score for pain intensity was significantly lower in the spray group (31.9; 95% confidence interval [CI], 22.0-41.7) compared with the control group (52.9; 95% CI, 45.9-60.0; P=.002), whereas there was no significant difference between the EMLA cream group (42.4; 95% CI, 34.2-50.7) and the control group. Patient satisfaction and preference for repeated use were higher in the spray group than the EMLA group.
  
  
  CONCLUSIONS
  Vapocoolant spray was more effective than EMLA cream in reducing pain during needle electromyography.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Catholic University Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Moon
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Won-Hyeok
authors.initials: WH
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000627:therapeutic use*; D016001:Confidence Intervals; D050785:Cryoanesthesia; D004338:Drug Combinations; D004576:Electromyography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D057240:Patient Preference; D017060:Patient Satisfaction; D011318:Prilocaine; D018709:Statistics, Nonparametric
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D011318:Prilocaine; D008012:Lidocaine