Effect of Ethyl Chloride Spray versus Ice Pack Application on Pain Perception in Patients Undergoing Radial Arterial Puncture: A Randomised Controlled Tria

Abstract

Introduction: Radial Arterial Puncture (AP) is much needed procedure in critical care setting but pain associated during AP makes patients anxious and stressed. Aim: To evaluate the efficacy of ethyl chloride spray versus ice pack application in decreasing pain during puncture of radial artery for Arterial Blood Gas (ABG) analysis. Materials and Methods: A randomised controlled parallel group design study was conducted in a tertiary care hospital in critical care units among 60 participants during November 2018 to December 2018. Seventy-two participants were initially recruited for this study who had to undergo ABG analysis out of them 12 were excluded and finally 60 participants were randomly allocated to ethyl chloride spray group (n=30) and ice pack application group (n=30). The assigned treatment was given just prior to radial AP. The primary outcome variable was to assess the level of pain score, which participants experienced during AP and measured by pain numerical rating scale while secondary outcome variable was incidence of haematoma within two hours after procedure. Data were presented in frequency, percentages, chi-square, Mann-Whitney U and Fisher’s-exact test. The statistical computer package, IBM Statistical Package for the Social Sciences (SPSS 23.0) was used for statistical analysis. Results: The mean pain score was 2.5±1.2 in the ethyl chloride group and 3.1±1.8 in ice pack application group (p=0.113); while incidence of haematoma was significantly high in ice pack application group as compared to ethyl chloride group (33.3% vs. 6.66%; p=0.01). Conclusion: Ethyl chloride spray and ice pack application have no significant difference in reducing pain intensity due to radial AP