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Comparative Study of the Effect of Lidocaine Spray and Ice Spray on the Pain Intensity During Intramuscular Injection: A Randomized Clinical Trial

Published:August 30, 2022DOI:https://doi.org/10.1016/j.pmn.2022.07.009

      Abstract

      Background

      Intramuscular injection is one of the most common, invasive, and painful ways to deliver medicine to the body.

      Aim

      Since one of the nurse's duties is to employ different methods to reduce pain caused by treatment procedures, this study was conducted to determine the effect of lidocaine spray and ice spray on pain intensity at the muscle injection site.

      Method

      A clinical trial was performed on 90 patients presenting to outpatient clinics of Neyshabur hospitals. The samples were selected using a computerized table of random numbers, and each participant was randomly assigned to one of the control, lidocaine spray, and ice spray groups. Pain severity was measured immediately after intramuscular injection using a numerical pain scale. Descriptive statistics along with statistical tests (chi-square, Fisher, etc.) were used to analyze the data in the R environment version 3.6.2. Ordinal logistic regression was used to compare pain intensity in the three groups by adjusting the effect of age variables and sensory disorders.

      Results

      The mean pain intensity was 3.44 without intervention, 2.63 with lidocaine spray, and 2.27 with ice spray. Statistical tests indicated a significant difference in pain intensity of intramuscular injection between the ice group and the control group (p = .010). Although lidocaine spray reduced the pain intensity, its effect was insignificant compared with the control group.

      Conclusions

      Both ice and lidocaine spray can be effectively used to reduce the intensity of intramuscular injection pain; however, it seems that ice spray is a more effective, safe, and affordable method.
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      References

        • Açmaz G.
        • Bayraktar E.
        • Aksoy H.
        • Başer M.
        • Yilmaz M.O.
        • Müderris I.I.
        Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, pethidine & diclofenac sodium application for pain relief during fractional curettage: A randomized controlled trial.
        Indian Journal of Medical Research. 2015; 142: 399-404
        • Aktaş Y.Y.
        • Karabulut N.
        The use of cold therapy, music therapy and lidocaine spray for reducing pain and anxiety following chest tube removal.
        Complementary Therapies in Clinical Practice. 2019; 34: 179-184
        • Arab V.
        • Bagheri-Nesami M.
        • Mousavinasab S.N.
        • Espahbodi F.
        • Pouresmail Z.
        Comparison of the effects of hegu point ice massage and 2% lidocaine gel on arteriovenous fistula puncture-related pain in hemodialysis patients: A randomized controlled trial.
        Journal of Caring Sciences. 2017; 6: 141-151
        • Asgari M.R.
        • Motlagh N.H.
        • Soleimani M.
        • Ghorbani R.
        Effect of lidocaine spray on the pain intensity during insertion of vascular needles in hemodialysis patients.
        Koomesh. 2013; 14: 271-279
        • Celik N.
        • Khorshid L.
        The use of ShotBlocker for reducing the pain and anxiety associated with intramuscular injection.
        Holistic Nursing Practice. 2015; 29: 261-271
        • Fiorelli A.
        • Pace C.
        • Cascone R.
        • Carlucci A.
        • De Ruberto E.
        • Izzo, Passavanti B.
        • Chiodini P.
        • Pota V.
        • Aurilio C.
        • Santini M
        Preventive skin analgesia with lidocaine patch for management of post-thoracotomy pain: Results of a randomized, double blind, placebo controlled study.
        Thoracic Cancer. 2019; 10: 631-641
        • Hawley P.
        • Fyles G.
        • Jefferys S.G.
        Subcutaneous Lidocaine for cancer-related pain.
        Journal of Palliative Medicine. 2020; 23: 1357-1364
        • Karasu Y.
        • Cömert D.K.
        • Karadağ B.
        • Ergün Y.
        Lidocaine for pain control during intrauterine device insertion.
        Journal of Obstetrics and Gynaecology Research. 2017; 43: 1061-1066
        • Lala K.R.
        • Lala M.K.
        Intramuscular injection: review and guidelines.
        Indian pediatrics. 2003; 40: 835-845
        • Mohiuddin I.
        • Setty J.V.
        • Srinivasan I.
        • Desai J.A.
        Topical application of local anaesthetic gel vs ice in pediatric patients for infiltration anaesthesia.
        Journal of Evolution of Medical and Dental Sciences. 2015; 4: 12934-12940
        • Mutlu S.
        • Yılmaz E.
        The effect of soft tissue injury cold application duration on symptoms, edema, joint mobility, and patient satisfaction: A randomized controlled trial.
        Journal of Emergency Nursing. 2020; 46: 449-459
        • Raddadi Y.
        • Adib-Hajbaghery M.
        • Ghadirzadeh Z.
        • Kheirkhah D.
        Comparing the effects of acupressure at LI4 and BL32 points on intramuscular injection pain.
        European Journal of Integrative Medicine. 2017; 11: 63-68
        • Şahiner N.C.
        • İnal S.
        • Akbay A.S.
        The effect of combined stimulation of external cold and vibration during immunization on pain and anxiety levels in children.
        Journal of Perianesthesia Nursing. 2015; 30: 228-235
        • Serena S.
        Rhythmic skin tapping: an effective measure to reduce procedural pain during IM injection.
        Nursing Journal of India. 2010; 101: 178-180
        • Seyedfatemi N.
        • Borimnejad L.
        • Hamooleh M.M.
        • Tahmasebi M.
        Iranian nurses’ perceptions of palliative care for patients with cancer pain.
        International Journal of Palliative Nursing. 2014; 20: 69-74
        • Simonsen L.
        • Kane A.
        • Lloyd J.
        • Zaffran M.
        • Kane M.
        Unsafe injections in the developing world and transmission of bloodborne pathogens: A review.
        Bulletin of the World Health Organization. 1999; 77: 789-800
        • Taddio A.
        • Nulman I.
        • Reid E.
        • Shaw J.
        • Koren G.
        Effect of lidocaine-prilocaine cream (EMLA®) on pain of intramuscular Fluzone® injection.
        Canadian Journal of Hospital Pharmacy. 1992; 45: 227-230
        • Valdovinos N.C.
        • Reddin C.
        • Bernard C.
        • Shafer B.
        • Tanabe P.
        The use of topical anesthesia during intravenous catheter insertion in adults: A comparison of pain scores using LMX-4 versus placebo.
        Journal of Emergency Nursing. 2009; 35: 299-304
        • Wang H.
        • Guan J.
        • Zhang X.
        • Wang X.
        • Ji T.
        • Hou D.
        • Wang G.
        • Sun J.
        Effect of cold application on pain and bruising in patients with subcutaneous injection of low-molecular-weight heparin: A meta-analysis.
        Clinical and Applied Thrombosis/Hemostasis. 2020; 26: 1-10
        • Yağiz On A.
        Cold applications for the treatment of pain.
        The Journal of the Turkish Society of Algology. 2006; 18: 5-14
        • Yarahmadi S.
        • Mohammadi N.
        • Ardalan A.
        • Najafizadeh H.
        • Gholami M.
        The combined effects of cold therapy and music therapy on pain following chest tube removal among patients with cardiac bypass surgery.
        Complementary Therapies in Clinical Practice. 2018; 31: 71-75
        • Yilmaz N.
        • Kiyak E.
        The effects of local cold application on fibromyalgia pain.
        International Journal of Rheumatic Diseases. 2017; 20: 929-934
        • Zore G.
        • Dias R.
        Effectiveness of nursing interventions on pain associated with intramuscular injection.
        International Journal of Science and Research. 2014; 3: 1995-2000