Analgesic Effect of Ice Cooling on Pain Perception Prior to Local Injection in Spinal Anesthesia: a Prospective Randomized Controlled Trial

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Prathana Wittayapairoch
Surachart Leeprasert
Suthannee Simajaruk
Kanya Panichkul


ntroduction: Spinal anesthesia is commonly used for many types of surgeries. To reduce the pain associated with spinal needle, subcutaneous local infiltration is administered beforehand. However, this process may still cause some pain. Previous studies have demonstrated that cooling the site of needle puncture with ice can decrease pain perception during needle insertion. Our study is aimed to evaluate the impact of ice cooling on pain perception during local infiltration in spinal anesthesia (SA). Methods: This prospective randomized controlled trial was conducted from August 2018 to March 2019. Participants aged 18 to 65 years undergoing SA were divided into two groups. Group C received standard SA, while group E received SA with ice cooling applied 5 min before local infiltration. Data on patient characteristics, pain scores during needle insertion and local injection, anxiety levels, patient satisfaction, and complications were recorded. Results: The study included 102 participants. Baseline characteristics were similar between two groups. The pain scores during needle insertion and local injection for local anesthesia showed no significant differences between the groups. Preoperative and postoperative anxiety and patient satisfaction scores also showed no significant variation. No severe complications related to procedure were reported. Conclusion: The application of ice cooling before local infiltration in SA showed no significant difference in the pain score during needle insertion and local infiltration for local anesthesia when compared to standard technique.

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