The effectiveness of ice as a topical anesthetic for the insertion of intravenous catheters

In a paired clinical trial, the effectiveness of ice in reducing the pain of intravenous catheter placement was assessed in 28 adult volunteers. An ice pack was placed over one arm for 10 minutes, followed by insertion of an 18-gauge angiocatheter in both arms. Patients recorded their pain assessment after each venipuncture on a previously validated 100-mm visual analog scale (VAS) and identified their preferred method for the procedure (pretreatment with ice or no pretreatment). The mean pain score for catheter placement on arms pretreated with ice was 27.5 ± 15.9 mm; the mean pain score for the control arms was 34.2 ± 21.6 mm (P = .17). Most patients (61%) preferred no pretreatment (P = .014). Although most men (75%) preferred no pretreatment, 75% of women preferred pretreatment with ice (P = .014). Future studies should examine whether ice is effective at reducing pain from other more painful procedures and whether the response to ice is gender-related.