Analgesic pretreatment for antibiotic skin test: vapocoolant spray vs ice cube.

Objectives: The objective of this study was to compare the efficacy of ethyl chloride spray and ice cube for the control of pain induced by the antibiotic skin test.

Methods: We performed a prospective, crossover, randomized study in which healthy adult volunteers received an intradermal skin test on both arms after different analgesic pretreatments. We assessed the pretreatment pain and discomfort after the intradermal skin injection using a 100-mm visual analogue scale.

Results: A total of 50 volunteers were enrolled in the study. The mean pain scores after the skin test were 32.4 +/- 17.6 and 54.7 +/- 22.4 mm, for the ice cube and vapocoolant spray pretreatment, respectively (P < .0001). The mean discomfort scores during pretreatment were 20.0 +/- 15.2 mm for ice cube and 10.5 +/- 11.5 mm for vapocoolant spray (P < .0001). Forty-five (90%) subjects preferred the ice cube pretreatment for the intradermal skin test.

Conclusions: The ice cube application was significantly more effective than the vapocoolant spray in reducing the pain of the antibiotic skin test. Hence, the ice cube pretreatment is suggested for easy and fast pain reduction for the antibiotic skin test in the emergency department.