J Korean Acad Nurs.  2018 Apr;48(2):221-231. 10.4040/jkan.2018.48.2.221.

The Effect of Pain Relieving Intervention During Infiltration among Gamma Knife Surgery Patients for Stereotactic Frame Fixation

• Jang YJ
• Kim HO

• KMID: 2410654
• DOI: http://doi.org/10.4040/jkan.2018.48.2.221

Abstract

PURPOSE
This study aimed to compare the effects of three interventions on pain, blood pressure, and pulse rate during infiltration anesthesia in patients about to undergo gamma knife surgeries.
METHODS
The three interventions employed in a university-affiliated Hospital in J City, South Korea were as follows: EMLA cream plus Vapocoolant spray (Vapocoolant, n=30), EMLA cream plus 10.0% Lidocaine spray (Lidocaine, n=30), and EMLA cream only (EMLA, n=30). The equivalent control-group pre test - post test study design was used. Pain was assessed subjectively using the numeric rating scale (NRS) and objectively using a Galvanic Skin Response (GSR) tester. NRS scores were assessed after infiltration anesthesia and the GSR was assessed during infiltration anesthesia. Blood pressure and pulse rate were assessed twice: before and after infiltration anesthesia. Data were collected between August 3, 2016 and March 24, 2017.
RESULTS
NRS scores after infiltration anesthesia and the GSR during infiltration anesthesia were significantly lower in the Vapocoolant group than in the Lidocaine and EMLA groups (F=13.56, p < .001 and F=14.43, p < .001, respectively). The increase in systolic blood pressure (F=4.77, p=.011) and in pulse rates (F=4.78, p=.011) before and after infiltration anesthesia were significantly smaller in the Vapocoolant group than in the Lidocaine and EMLA groups; however, no significant differences were observed in diastolic blood pressures (F=1.51, p=.227).
CONCLUSION
EMLA cream plus Vapocoolant spray was the most effective intervention to relieve pain and to lower increase in systolic blood pressure and pulse rate caused by infiltration anesthesia for stereotactic frame fixation. Thus, application of Vapocoolant spray in addition to EMLA cream is highly recommended as a nursing intervention for patients undergoing gamma knife surgeries.

Keyword

Neurosurgery; Pain; Local Anesthesia; Galvanic Skin Response; Nursing

MeSH Terms

Anesthesia, Local
Blood Pressure
Galvanic Skin Response
Heart Rate
Humans
Korea
Lidocaine
Neurosurgery
Nursing
Lidocaine

Figure

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  Figure 1. Randomized controlled trial flow diagram.

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  Figure 2. Flow of the study.

Reference

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