title: Comparing the effectiveness of vapocoolant spray and lidocaine/procaine cream in reducing pain of intravenous cannulation: A randomized clinical trial.
abstract: BACKGROUND
  Venous cannulation is the most common procedure in emergency departments. The aim of this study was to compare the effectiveness of vapocoolant spray and EMLA cream in reduction of pain during venous cannulation in 6-12years old children.
  
  
  METHODS
  The study was a randomized clinical trial with a crossover design. It took place between June and December 2015 at Ali-Asghar hospital in Tehran, Iran. 40 Thalassemic children who need regular blood transfusions were randomly assigned in two groups. The pain of intravenous cannulation was measured using a visual analogue scale for pain (VAS-P). With the crossover design each patient received vapocoolant spray and EMLA cream in the next two visits. The patients were allocated into two groups (A and B). The patients in Group (A) received Vapocoolant spray in the first visit and EMLA cream in the second visit before intravenous cannulation. The patients in Group (B) group were exposed to the opposite order.
  
  
  RESULTS
  The pain after Vapocoolant spray was 3.22±1.18 which was significantly lower than control (7.12±1.36) and higher than EMLA cream (0.77±1.09), p>0.001. The anxiety before cannulation had a significant effects on the reported pain by children. The ANCOVA showed that despite the effects of anxiety the results did not change significantly.
  
  
  CONCLUSIONS
  The results indicated that vapocoolant spray was not as effective as EMLA cream, in the event of an emergency and in patients with allergic reactions to lidocaine and procaine ingredients Vapocoolant is an efficacious alternative.
authors.affiliation: University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: dalvandi@uswr.ac.ir.
authors.forename: Asghar
authors.initials: A
authors.lastname: Dalvandi
authors.affiliation: Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: ranjbar.h@iums.ac.ir.
authors.forename: Hadi
authors.initials: H
authors.lastname: Ranjbar
authors.affiliation: University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: maryamhatamizadeh@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hatamizadeh
authors.affiliation: University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: rahgouin@yahoo.com.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Rahgoi
authors.affiliation: Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: Colleen.Bernstein@wits.ac.za.
authors.forename: Colleen
authors.initials: C
authors.lastname: Bernstein
mesh_terms: D000287:Administration, Topical; D000336:Aerosols; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001007:Anxiety; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods; D002648:Child; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007492:Iran; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D009824:Ointments; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011343:Procaine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000336:Aerosols; D000779:Anesthetics, Local; D009824:Ointments; D011343:Procaine; D008012:Lidocaine
keywords: Children; Crossover trial; Pain; Topical anesthetics; Venous cannulation