Topical anesthetic spray before procedures?

[tmvguy03]

Hey all- I don't do this in my practice, but am considering for certain patients. Do you use any type of local anesthetic spray before procedures? Only for skittish patients or those who request? For all my procedures, RFA/SCS trials it is local only, +/- valium.
My primary concern was possible increased infection risk, but apparently there have been some studies looking at this without any considerable infection risk- also if I did, could spray, then chloroprep after which should mitigate.

---

Members don't see this ad.

 

[dc2md]

Don't do it unless patient requests it, which rarely happens.

Sent from my Pixel 4 XL using Tapatalk

 

[Ferrismonk]

I do it for knees or shoulders if asked. I don't do it for spinal injections due to potential infection risk (ethyl chloride spray isn't considered sterile).
Spraying before prep wouldn't help, as the anesthetic/cooling effect is from evaporation and dissipates quickly.

That being said, I know a local guy who uses the spray for spinal injections and hasn't had any trouble that I know of.

I've been thinking about using the buzzy device. Still deciding if I want to go there or not. You'd have to use a sterile ultrasound cover or something on it as well.

Healthcare & Pharmaceutical Pain Relief Solutions

Join the thousands of hospitals and clinics who have improved patient care and satisfaction. Explore Pain Care Labs products and services.

buzzyhelps.com

 

[Cholula]

I trained with using ethyl chloride spray. I haven't had any known infections from its use. A tip though is to prep a big area as the spray can splash and wash an unpreped area into your sterile area, alternatively you can spray it onto a cotton ball or sterile gauze and apply it to your injection site. Ethyl chloride is not available as it is flammable. I'm using a pentafluoropropane and tetrafluoroethane product. if you use it a lot there is a cost to it, over $30/can.

 

[Ducttape]

I use topical spray for most of my non-neuraxial procedures, such as simple nerve blocks, simple joints and the occasional trigger point.. spray until it blanches, chloroprep, then inject.

by the company paperwork, the local anesthetic effect is more than the immediate blanching, and that seems consistent with my experience.

 

[tmvguy03]

Good thoughts- I would envision using this sparingly- like a couple times a week, but it may be a good thing to offer if someone requests.

 

[cowboydoc]

I do it for knees or shoulders if asked. I don't do it for spinal injections due to potential infection risk (ethyl chloride spray isn't considered sterile).
Spraying before prep wouldn't help, as the anesthetic/cooling effect is from evaporation and dissipates quickly.

That being said, I know a local guy who uses the spray for spinal injections and hasn't had any trouble that I know of.

I've been thinking about using the buzzy device. Still deciding if I want to go there or not. You'd have to use a sterile ultrasound cover or something on it as well.

Healthcare & Pharmaceutical Pain Relief Solutions

Join the thousands of hospitals and clinics who have improved patient care and satisfaction. Explore Pain Care Labs products and services.

buzzyhelps.com

You may be on to something. We got this for my child who was getting stuck regularly. Helped significantly. Think a tegaderm would work well to put it on the sterile field. I would only use on the "1%" most skittish patients.

Also, met the inventor (MD pediatric ER, IIRC) at AAPM&R this year. Developing an ice pack with similar device, which may be nice post-operatively, may be worthwhile for some of our patients.

 

[dc2md]

I do it for knees or shoulders if asked. I don't do it for spinal injections due to potential infection risk (ethyl chloride spray isn't considered sterile).
Spraying before prep wouldn't help, as the anesthetic/cooling effect is from evaporation and dissipates quickly.

That being said, I know a local guy who uses the spray for spinal injections and hasn't had any trouble that I know of.

I've been thinking about using the buzzy device. Still deciding if I want to go there or not. You'd have to use a sterile ultrasound cover or something on it as well.

Healthcare & Pharmaceutical Pain Relief Solutions

Join the thousands of hospitals and clinics who have improved patient care and satisfaction. Explore Pain Care Labs products and services.

buzzyhelps.com

Funny. I thought about this thing a few years ago. The vibration would have to be close to the injection site. Literally, a vibrator with a sterile condom would work the best. But I'm not about to try that.

Sent from my Pixel 4 XL using Tapatalk

 

[tmvguy03]

Funny. I thought about this thing a few years ago. The vibration would have to be close to the injection site. Literally, a vibrator with a sterile condom would work the best. But I'm not about to try that.

Sent from my Pixel 4 XL using Tapatalk

A definite way to elicit a "wtf" from the patient

 

[cowboydoc]

Funny. I thought about this thing a few years ago. The vibration would have to be close to the injection site. Literally, a vibrator with a sterile condom would work the best. But I'm not about to try that.

Sent from my Pixel 4 XL using Tapatalk

And your equipment would disappear from your clinic faster than a bottle of hand sanitizer!