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Ethyl Chloride as a Cryoanalgesic in Pediatrics for Venipuncture

Soueid, Ali MSc, MRCS, MB, BCh, BAO*; Richard, Bruce FRCS

doi: 10.1097/01.pec.0000278396.25129.3f
Original Articles

Introduction: Ethyl chloride can be used as a cryoanalgesic, but with the availability of alternative and relatively safer topical analgesics, its use has decreased. However, it still has the advantage of being quicker to apply compared with other topical analgesics, making it ideal for use in the outpatient departments. We wanted to compare the effectiveness of ethyl chloride as an analgesic during venipuncture in children.

Methods: Venipuncture was carried out using either no analgesia (NO), ethyl chloride spray (EC), or application of the topical anesthetic Ametop (TA) on children attending the phlebotomy outpatient service by experienced pediatric phlebotomists. A pain score was recorded using either the Faces scoring system or the Faces, Legs, Activity, Cry Consolability scoring system.

Results: A total of 55 patients were included in the study, 18 from group EC, 18 from group TA, and 19 from group NO. Thirteen patients from both groups EC and TA and 17 from group NO scored 2 or less on the pain scores.

Discussion: The use of ethyl chloride was as effective as topical anesthetics in preventing distress to children in venipuncture. However, in the appropriate situations, the use of NO could also be comfortable to the child if venipuncture was done by specialist pediatric phlebotomists.

*Plastic Surgery Department, Frenchay Hospital, Frenchay Park Rd, Bristol and †Plastic Surgery Department, Birmingham Children's Hospital, Birmingham, UK.

Address correspondence and reprint requests to Ali Soueid, MSc, MRCS, MB, BCh, BAO, 4F Lanhill Road, London W9 2BP, UK. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.