Rasooli Fatemeh, Sotoodehnia Mehran, Nejati Amir, Payandemehr Pooya
Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Turk J Emerg Med. 2020 Mar 31;20(2):81-85. doi: 10.4103/2452-2473.281628. eCollection 2020 Apr-Jun.
Digital nerve block is a painful procedure. Several methods have been proposed to decrease the injection pain. Applying an ice pack is a pertinent choice due to its effectiveness on pain reduction, convenience, and low costs. In this study, the degree of injection pain reduction was assessed after applying an ice pack to the site of anesthetic injection.
One hundred participants with traumatic finger injury were assessed. Digital nerve block was performed in fifty patients in the intervention group after 6 min of ice application. In the control group, this procedure was done without ice. The primary outcome was the difference between the needle stick and infiltration pain scores with and without ice pack. The secondary outcome the patient satisfaction score. The protocol of this study was approved by the Institutional Review Board, and it is registered in the Iranian Registry of Clinical Trials.
The pain score was assessed using a Numeric Rating Scale. Both the needle skin and infiltration pain scores were statistically significantly lower in the intervention group ( < 0.001). The mean and median needle stick pain scores were 1.5 and 1.0 in the intervention group and 6.8 and 7.0 in the control group, respectively. Moreover, the mean and median infiltration pain scores were 2.7 and 2.0 in the intervention group and 8.5 and 9.0 in the control group, respectively. Patient satisfaction score was significantly higher in the intervention group.
Ice pack is inexpensive, readily available, and is easy to apply. We recommend this method to reduce the injection pain before digital nerve block in the emergency department.
指神经阻滞是一种会引起疼痛的操作。已经提出了几种方法来减轻注射疼痛。应用冰袋是一个合适的选择，因为它在减轻疼痛方面有效、方便且成本低。在本研究中，评估了在麻醉注射部位应用冰袋后注射疼痛减轻的程度。
对100名手指外伤患者进行评估。干预组的50名患者在冰敷6分钟后进行指神经阻滞。对照组在不使用冰袋的情况下进行该操作。主要结局是有无冰袋时的针刺和浸润疼痛评分之间的差异。次要结局是患者满意度评分。本研究方案已获得机构审查委员会的批准，并已在伊朗临床试验注册中心注册。
使用数字评分量表评估疼痛评分。干预组的针刺皮肤和浸润疼痛评分在统计学上均显著更低（<0.001）。干预组的平均和中位数针刺疼痛评分分别为1.5和1.0，对照组分别为6.8和7.0。此外，干预组的平均和中位数浸润疼痛评分分别为2.7和2.0，对照组分别为8.5和9.0。干预组的患者满意度评分显著更高。
冰袋价格便宜、容易获得且易于应用。我们建议在急诊科进行指神经阻滞前使用这种方法来减轻注射疼痛。
