Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
Department of Emergency Medicine, Manisa Merkez Efendi State Hospital, Manisa, Turkey.
Am J Emerg Med. 2020 Jul;38(7):1458-1462. doi: 10.1016/j.ajem.2019.12.054. Epub 2020 Jan 7.
Coolant spray application in musculoskeletal injuries is an effective and harmless method to treat pain and reduce functional limitation. This study assessed the clinical value of coolant spray application on patient comfort before and during the radiographic imaging process along with its early analgesic and anti-edema effects.
A total of 155 patients, admitted to the emergency department between April 1, 2019, and June 31, 2019, were included in this study. The patients were randomly assigned to either a coolant spray or a saline spray (placebo) group. To the coolant spray group patients, Cryos ®Spray (Phyto Performance, Italy) was applied. To the placebo group patients, a normal saline solution in a bottle covered with white opaque paper and refrigerated at 4 °C was sprayed. Radiographic images of the patients were scored for appropriateness of the standard imaging characteristics.
The mean scores were 8.13 ± 1.8 and 6.58 ± 2.2 for the coolant spray and normal saline spray groups, respectively; the differences were statistically significant between the two groups (mean difference: -1.56, 95% CI:-2.20 to -0.92; p = .000). Patients with fractures on their radiographs and treated with coolant spray received higher scores than similar patients treated with normal saline spray (mean difference:-1.92, 95% CI:-3.28 to -0.55; p = .009). The proportion of patients requesting analgesic treatment before discharge was statistically lower in the coolant spray group compared to the normal saline group (p = .025).
The radiographic images taken after coolant spray intervention in patients with acute ankle trauma were more successful in showing the target structures.
在肌肉骨骼损伤中应用冷却剂喷雾是一种有效且无害的方法,可治疗疼痛并减轻功能受限。本研究评估了在放射成像过程前后,冷却剂喷雾应用对患者舒适度的临床价值,以及其早期镇痛和抗水肿效果。
本研究共纳入 155 名 2019 年 4 月 1 日至 6 月 31 日期间因急性踝关节损伤就诊于急诊的患者。患者被随机分为冷却剂喷雾组或盐水喷雾(安慰剂)组。对冷却剂喷雾组患者,使用 Cryos®Spray(Phyto Performance,意大利)喷雾。对安慰剂组患者,使用冷藏在 4°C 下的白色不透明纸覆盖的瓶装生理盐水喷雾。对患者的放射图像进行评分,以评估标准成像特征的适宜性。
冷却剂喷雾组和生理盐水喷雾组的平均评分为 8.13±1.8 和 6.58±2.2,两组之间的差异具有统计学意义(平均差值:-1.56,95%置信区间:-2.20 至-0.92;p=0.000)。在放射图像上有骨折且接受冷却剂喷雾治疗的患者比接受生理盐水喷雾治疗的类似患者获得更高的评分(平均差值:-1.92,95%置信区间:-3.28 至-0.55;p=0.009)。与生理盐水组相比,冷却剂喷雾组在出院前要求镇痛治疗的患者比例统计学上更低(p=0.025)。
在急性踝关节创伤患者中进行冷却剂喷雾干预后获得的放射图像更成功地显示了目标结构。