Comparison of the effects of vapocoolant spray and topical anesthetic cream on pain during needle electromyography in the medial gastrocnemius.

Abstract

To compare the effects of a vapocoolant spray and an eutectic mixture of local anesthetics (EMLA) cream in reducing pain during needle electromyography examination. Randomized controlled trial. Physical medicine and rehabilitation department of a university hospital. Adults who underwent needle electromyography (N=99) were randomized to 1 of 2 experimental groups or the control group. Two patients dropped out during the study. In the experimental groups, vapocoolant spray or EMLA cream were applied before needle electromyography. In the control group, needle electromyography was performed without pretreatment. Intensity of pain associated with needle electromyography was assessed using a 100-mm visual analog scale (VAS). Patient satisfaction and preference for repeated use were measured using a 5-point Likert scale. VAS score for pain intensity was significantly lower in the spray group (31.9; 95% confidence interval [CI], 22.0-41.7) compared with the control group (52.9; 95% CI, 45.9-60.0; P=.002), whereas there was no significant difference between the EMLA cream group (42.4; 95% CI, 34.2-50.7) and the control group. Patient satisfaction and preference for repeated use were higher in the spray group than the EMLA group. Vapocoolant spray was more effective than EMLA cream in reducing pain during needle electromyography.