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Local anesthesia can reduce pain during intravenous catheter insertion, but topical anesthesia takes too long for emergency department use, and infiltration anesthesia has not really caught on. Is there a simpler way? Australian researchers prospectively randomized a convenience sample of 201 adult patients (54% male; mean age, 58) to be sprayed with either water or vapocoolant (a blend of propane, butane, and pentane) from a distance of 12 cm for 2 seconds, within 15 seconds before IV cannulation.
Significantly fewer patients in the vapocoolant group than in the water group had moderate or severe pain (measured on a 100-mm visual analog scale) from IV catheterization (32% vs. 60%). More patients in the vapocoolant group than in the placebo …