Emergency Care Journal · Published 2026-05-22 · DOI 10.4081/ecj.2026.14680
Chawin Taveekijakarn, Tuntanut Lohawatcharagul, Supichaya Vitoonpanakoon, Pornchanok Sirisantisamrid, Thanathip Suenghataiphorn, Peerada Valyasevi, Ponphisudti Tangsirisatian
This study evaluated the efficacy of topical anaesthesia and cryo-analgesia for pain management during radial Arterial Blood Gas (ABG) sampling, compared with standard care. An open-label, randomised controlled trial with blinded statistical analysis in a Thai emergency department (July–September 2024) included 126 adults requiring ABG sampling. Participants were randomised to receive topical anaesthesia (10% lidocaine spray), cryo-analgesia (cold pack), or standard care (2% chlorhexidine) two minutes prior to the procedure. The primary outcome was participant-reported pain, assessed via the Numeric Rating Scale (NRS) during the procedure and 30 seconds post-procedure. ANOVA determined significant differences in pain scores. Statistical significance was set at p<0.05. All 126 participants completed the study (42 participants per group). Mean NRS pain scores did not differ significantly among the groups during the procedure [F(2,123)=0.62, p=0.54] or 30 seconds post-procedure [F(2,123)=0.35, p=0.71] Cryo-analgesia achieved the highest first-attempt success rate (83.3%, p=0.42). No immediate complications occurred within 5 minutes. Neither topical anaesthesia nor cryo-analgesia provided superior pain management compared with standard care during radial ABG sampling. These findings represent an absence of evidence for superiority, rather than evidence of clinical equivalence.
Abstract from DOAJ. Public domain (CC0 1.0).
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Taveekijakarn, C., Lohawatcharagul, T., Vitoonpanakoon, S., et al. (2026). Comparison of low-cost interventions for pain during radial arterial blood gas sampling in the emergency department: a three-arm randomised controlled trial. Emergency Care Journal. https://doi.org/10.4081/ecj.2026.14680