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Objective: To determine if ethyl chloride spray provides adequate analgesia prior to injections. Design: Systematic literature review. Methods: A search was conducted in both Pubmed and Scopus using search terms ethyl chloride and injection. The Pubmed search was narrowed to include studies within a 10-year publication range. Articles were excluded based on: population age range, date of publication, and if ethyl chloride was used in conjunction with another analgesic. There were no relevant articles in the Scopus search. Results: Franko O, Stern P. demonstrated that there was no statistically significant improvement in anxiety or pain perceived with ethyl chloride treatment as compared to the control.1 Irkoren et al. found that ethyl chloride spray and Eutectic Mixture of Local Anesthetic (EMLA) cream each significantly decreased the pain associated with forehead botulinum toxin (BTX) injections when compared to the control.2 The majority of patients preferred the ethyl chloride spray over the EMLA cream as an analgesic.2 Moon et al. determined lidocaine and ethyl chloride are equally effective methods for decreasing pain associated with injections.3 Ethyl chloride spray had the added benefit of a lack of metallic taste.3 Conclusion: We cannot conclude that ethyl chloride spray is an effective analgesic prior to injections in men and women. However, we do recommend its use prior to BTX forehead injections and dorsal hand propofol injections in women age 18 and older, based on results from Irkoren et al. and Moon et al.2,3
Kappe M, Pyles R. Ethyl Chloride Spray for Injection Site Analgesia. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones/34/. Published December 12, 2018.