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Original research| Volume 101, ISSUE 10, P1689-1695, October 2020

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Comparison of the Effects of Vapocoolant Spray and Topical Anesthetic Cream on Pain During Intraarticular Injection of the Shoulder: A Randomized Double-Blind Controlled Trial

      Abstract

      Objective

      This study was performed to compare the effects of a vapocoolant spray and a eutectic mixture of local anesthetics (EMLA) cream on reducing pain during intra-articular (IA) injection of the shoulder.

      Design

      Double-blind randomized placebo-controlled clinical trial.

      Setting

      University hospital.

      Participants

      Patients (N=63) who underwent IA injection of the shoulder joint were randomized into the spray group, EMLA group, or placebo group.

      Intervention

      Placebo cream+vapocoolant spray (spray group), EMLA cream+placebo spray (EMLA group), or placebo cream+placebo spray (placebo group) before IA injection.

      Main Outcome Measures

      A 100-mm visual analog scale (VAS) for injection pain and 5-point Likert scales for participant satisfaction and preference for repeated use were administered immediately after IA injection.

      Results

      The VAS scores for pain during IA injection were 30.0 (95% CI, 19.7-41.2) in the spray group, 50.0 (95% CI, 37.7-63.0) in the EMLA group, and 53.8 (95% CI, 41.6-65.0) in the placebo group (F=6.403, P<.01). The spray group showed significantly better Likert scale scores than the placebo group for participant satisfaction (P=.003) and preference for repeated use (P<.001).

      Conclusions

      Vapocoolant spray was effective in reducing pain during IA injection of the shoulder.

      Keywords

      List of abbreviations:

      EMLA (eutectic mixture of local anesthetics), HA (hyaluronic acid), IA (intra-articular), SPADI (Shoulder Pain and Disability Index), VAS (visual analog scale)
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