Fatemeh Rasooli1 , Mehran Sotoodehnia1 , Amir Nejati2 , Pooya Payandemehr1

1Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
2Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran

Keywords: Digital nerve block, ice packing, pain


OBJECTIVES: Digital nerve block is a painful procedure. Several methods have been proposed to decrease the injection pain. Applying an ice pack is a pertinent choice due to its effectiveness on pain reduction, convenience, and low costs. In this study, the degree of injection pain reduction was assessed after applying an ice pack to the site of anesthetic injection.

METHODS: One hundred participants with traumatic finger injury were assessed. Digital nerve block was performed in fifty patients in the intervention group after 6 min of ice application. In the control group, this procedure was done without ice. The primary outcome was the difference between the needle stick and infiltration pain scores with and without ice pack. The secondary outcome the patient satisfaction score. The protocol of this study was approved by the Institutional Review Board, and it is registered in the Iranian Registry of Clinical Trials.

RESULTS: The pain score was assessed using a Numeric Rating Scale. Both the needle skin and infiltration pain scores were statistically significantly lower in the intervention group (P < 0.001). The mean and median needle stick pain scores were 1.5 and 1.0 in the intervention group and 6.8 and 7.0 in the control group, respectively. Moreover, the mean and median infiltration pain scores were 2.7 and 2.0 in the intervention group and 8.5 and 9.0 in the control group, respectively. Patient satisfaction score was significantly higher in the intervention group.

CONCLUSIONS: Ice pack is inexpensive, readily available, and is easy to apply. We recommend this method to reduce the injection pain before digital nerve block in the emergency department.

How to cite this article: Rasooli F, Sotoodehnia M, Nejati A, Payandemehr P. The assessment of ice pack effect in pain reduction during digital nerve block: A randomized clinical study. Turk J Emerg Med 2020;20:81-5

Ethics Committee Approval

The protocol of the study was approved by the Tehran University of Medical Sciences’ Institutional Review Board (Date and Number). This study was registered in the Iranian Registry of Clinical Trials. (IRCT2017010731807N1).

Author Contributions

RF, NA and PP designed the study. SM registered this trial in Iranian Registry of Clinical Trial. RF was responsible of collecting data and explanation of the study to the patients. PP, RF and SM designed method and analyzed data. All authors contributed in all aspects of the trial.

Conflict of Interest

None declared.

Financial Disclosure

None declared.