Comparison of Lidocaine-Prilocaine Combination and Vapocoolant for IV Cannulation Pain in the ED

Study Overview
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Brief Summary
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Hypothesis: Lidocaine-Prilocaine Combination is as effective as Vapocoolant in treating IV cannulation pain in the emergency department.

Detailed Description
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Lidocain-Prilocaine combination cream is two amide-type local anesthetics used for topical skin anesthesia. Vapocoolant spray is also another method for providing appropriate analgesia through crayoanesthetic mechanisms. Although there are some contraindications and adverse effects, these are widely used in the Emergency Department (ED) for IV cannulation pain.

Official Title
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Comparison of The Efficacy of Lidocaine-Prilocaine Combination and Vapocoolant Spray to Reduce Pain of IV Cannulation in The Emergency Department: A Randomized Clinical Trial

Conditions
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Pain

Intervention / Treatment
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* Drug: Vapocoolant spray
* Drug: Lidocaine-Prilocaine cream


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Low acute patients who are waiting for the admission to the ED and require IV cannulation Exclusion Criteria: Altered mental status Uncooperative patients Unable to communicate Known history of hypersensitivity reaction to cold or amid analgesics Analgesic usage in previous 6 hours No consent Emergent condition Pregnancy and lactation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Vapocoolant spray<br>Patients in this arm will receive vapocoolant spray before IV cannulation. | Drug: Vapocoolant spray<br>* The spray will be applied continuously from 25 cm distance for less than 5 seconds to the cannulation site.<br>|
| Active Comparator: Lidocaine-Prilocaine cream<br>Patients in this arm will receive Lidocaine-Prilocaine cream before IV cannulation. | Drug: Lidocaine-Prilocaine cream<br>* A finger tip (0.5 gr) of the cream will be applied in 4 square cm at cannulation site and will be covered with closed dressing for 45 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cannulation pain: numerical rating score (NRS) | The numerical rating score (NRS) will be used for the study. The NRS ranges from 0 (no pain) to 10 (very severe pain). The higher the pain scores the higher the pain severity. The pain severity will be asked from the patients. | immediately after the procedure. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Application pain: numerical rating score (NRS) | The numerical rating score (NRS) will be used for the study. The NRS ranges from 0 (no pain) to 10 (very severe pain). The higher the pain scores the higher the pain severity. The pain severity will be asked from the patients. | immediately after the procedure. | 
| Catheterization attempts | Number of times the direction of IV catheter is changed before the successful cannulation. Exit from the skin is also considered an attempt. | immediately after the procedure. |