School of Nursing, Weifang Medical University, Weifang, China.
Weifang People's Hospital, Weifang, China.
PLoS One. 2023 Feb 13;18(2):e0279463. doi: 10.1371/journal.pone.0279463. eCollection 2023.
The aim was to evaluate the effectiveness and safety of the vapocoolants for vascular puncture in children and adults.
The search was carried out in PubMed, Web of Science, Embase and The Cochrane Library, from inception to March 2022. Randomized controlled trials comparing vapocoolants to control conditions for participants received intravenous cannulation or arterial puncture were included. Two reviewers independently performed selection of studies, data extraction, and assessment of risk of bias. The analysis was performed using fixed or random-effects model with mean differences or standardized mean difference and risk ratios.
A total of 25 studies involving 3143 participants were included. Compared with control conditions, vapocoolants may not decrease the pain of patients with arterial puncture (SMD = -0.36, 95% CI = -0.92 to -0.19, P = 0.20), but may more effectively relieve pain for adults received vein puncture (SMD = -0.65, 95% CI = -0.85 to -0.45, P < 0.00001). The application of vapocoolant increased the procedural difficulty of medical personnel (RR = 2.49, 95% CI = 1.62 to 3.84, P<0.000 1) and participants were more willing to use the spray in the future (RR = 1.88, 95% CI = 1.34 to 2.64, P = 0.0002). There was no significant difference for the first attempt success rate of the procedure and the occurrence of adverse events.
Vapocoolant spray may relieve pain in adults received vein puncture and cannot cause severe side effects, but is ineffective in children. It also had no effect on patients with arterial puncture. In addition, the application of spray increases procedural difficulties for medical professionals, but does not decrease first attempt success rate, and many patients would like to use the spray again for pain relief in the future. Thus, more rigorous and large-scale studies are needed to determine its effectiveness in vascular access.
评估血管穿刺用 vapocoolants 在儿童和成人中的有效性和安全性。
检索 PubMed、Web of Science、Embase 和 The Cochrane Library，时间截至 2022 年 3 月。纳入 vapocoolants 与静脉穿刺或动脉穿刺参与者的对照条件比较的随机对照试验。两名审查员独立进行研究选择、数据提取和偏倚风险评估。使用固定或随机效应模型进行分析，采用均数差值或标准化均数差值和风险比。
共纳入 25 项研究，涉及 3143 名参与者。与对照条件相比， vapocoolants 可能无法减轻动脉穿刺患者的疼痛（SMD=-0.36，95%CI=-0.92 至-0.19，P=0.20），但可能更有效地缓解成人静脉穿刺的疼痛（SMD=-0.65，95%CI=-0.85 至-0.45，P<0.00001）。 vapocoolant 的应用增加了医务人员操作的难度（RR=2.49，95%CI=1.62 至 3.84，P<0.0001），参与者未来更愿意使用喷雾（RR=1.88，95%CI=1.34 至 2.64，P=0.0002）。操作的首次尝试成功率和不良事件的发生率没有显著差异。
vapocoolant 喷雾可能缓解成人静脉穿刺疼痛，不会引起严重的副作用，但对儿童无效。它对动脉穿刺患者也没有影响。此外，喷雾的应用增加了医疗专业人员操作的难度，但不会降低首次尝试成功率，而且许多患者将来会希望再次使用喷雾来缓解疼痛。因此，需要更严格和大规模的研究来确定其在血管通路中的有效性。
