Nicola Pagnucci1, Salvatore Pagliaro2, Claudia Maccheroni2, Marco Sichi2, Monica Scateni2, Angela Tolotti3. 1. Department of Clinical and Experimental Medicine, Universita degli Studi di Pisa Dipartimento di Medicina Clinica e Sperimentale, Pisa, Italy. 2. Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. 3. Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland.
Abstract
BACKGROUND: Taking a sample of arterial blood is widely reported as a cause of significant pain. OBJECTIVES: To compare three anesthetic methods with standard practice (no anesthesia) to establish which was the most effective in reducing pain caused by radial artery puncture in patients requiring an arterial blood gas test in the emergency department (ED). METHODS: A randomized controlled trial was conducted to compare the effectiveness between anesthetic cream, cryoanalgesia, and subcutaneous mepivacaine in reducing pain caused by radial artery puncture in ED patients. RESULTS: After comparing perceived pain during arterial puncture, the lowest median score was obtained in the mepivacaine group (1 interquartile range 0.6-1.3) and the highest median score in the control group (5 interquartile range 4.0-7.0). When comparing the control group with the three intervention groups, the Kruskal-Wallis test showed that mepivacaine (p = 0.023) and cryoanalgesia (p = 0.012) were associated with significantly lower pain scores. The anesthetic cream (p = 0.861) intervention group did not produce a statistically significant median difference compared with the control group. CONCLUSIONS: The results of this study encourage the use of anesthetic methods like cryoanalgesia or mepivacaine for their proven effectiveness in reducing or eliminating pain during arterial puncture.
RCT Entities:
BACKGROUND: Taking a sample of arterial blood is widely reported as a cause of significant pain. OBJECTIVES: To compare three anesthetic methods with standard practice (no anesthesia) to establish which was the most effective in reducing pain caused by radial artery puncture in patients requiring an arterial blood gas test in the emergency department (ED). METHODS: A randomized controlled trial was conducted to compare the effectiveness between anesthetic cream, cryoanalgesia, and subcutaneous mepivacaine in reducing pain caused by radial artery puncture in ED patients. RESULTS: After comparing perceived pain during arterial puncture, the lowest median score was obtained in the mepivacaine group (1 interquartile range 0.6-1.3) and the highest median score in the control group (5 interquartile range 4.0-7.0). When comparing the control group with the three intervention groups, the Kruskal-Wallis test showed that mepivacaine (p = 0.023) and cryoanalgesia (p = 0.012) were associated with significantly lower pain scores. The anesthetic cream (p = 0.861) intervention group did not produce a statistically significant median difference compared with the control group. CONCLUSIONS: The results of this study encourage the use of anesthetic methods like cryoanalgesia or mepivacaine for their proven effectiveness in reducing or eliminating pain during arterial puncture.
Authors: Eduardo Butturini de Carvalho; Thiago Ravache Sobreira Leite; Raquel Ferreira de Magalhães Sacramento; Paulo Roberto Loureiro do Nascimento; Cynthia Dos Santos Samary; Patrícia Rieken Macedo Rocco; Pedro Leme Silva Journal: Rev Bras Ter Intensiva Date: 2022 Jan-Mar