• Young-Eun Moon, Sang-Hyun Kim, and Won-Hyeok Choi.
• Department of Anesthesiology and Pain Medicine, Catholic University Seoul St. Mary's Hospital, Seoul, Korea.
• Arch Phys Med Rehabil. 2013 May 1;94(5):919-24.

ObjectiveTo compare the effects of a vapocoolant spray and an eutectic mixture of local anesthetics (EMLA) cream in reducing pain during needle electromyography examination.DesignRandomized controlled trial.SettingPhysical medicine and rehabilitation department of a university hospital.ParticipantsAdults who underwent needle electromyography (N=99) were randomized to 1 of 2 experimental groups or the control group. Two patients dropped out during the study.InterventionsIn the experimental groups, vapocoolant spray or EMLA cream were applied before needle electromyography. In the control group, needle electromyography was performed without pretreatment.Main Outcome MeasuresIntensity of pain associated with needle electromyography was assessed using a 100-mm visual analog scale (VAS). Patient satisfaction and preference for repeated use were measured using a 5-point Likert scale.ResultsVAS score for pain intensity was significantly lower in the spray group (31.9; 95% confidence interval [CI], 22.0-41.7) compared with the control group (52.9; 95% CI, 45.9-60.0; P=.002), whereas there was no significant difference between the EMLA cream group (42.4; 95% CI, 34.2-50.7) and the control group. Patient satisfaction and preference for repeated use were higher in the spray group than the EMLA group.ConclusionsVapocoolant spray was more effective than EMLA cream in reducing pain during needle electromyography.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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