Does Ethyl Chloride Spray Work?

NCT ID: NCT06651788

Last Updated: 2025-10-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-01

Study Completion Date

2028-12-01

Brief Summary

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A procedure frequently performed by orthopaedic providers is the administration of corticosteroid injections for the management of various soft tissues and joint-related conditions, such as osteoarthritis, tendinitis, carpal tunnel syndrome, trigger finger, and de Quervain's tenosynovitis. While these injections have demonstrated effectiveness in alleviating symptoms, the discomfort associated with the procedure can be a source of anxiety and apprehension for patients. This discomfort arises from the sensation of the needle entering the affected area and the burning sensation induced by the corticosteroid solution.

Detailed Description

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A procedure frequently performed by orthopaedic providers is the administration of corticosteroid injections for the management of various soft tissues and joint-related conditions, such as osteoarthritis, tendinitis, carpal tunnel syndrome, trigger finger, and de Quervain's tenosynovitis. While these injections have demonstrated effectiveness in alleviating symptoms, the discomfort associated with the procedure can be a source of anxiety and apprehension for patients. This discomfort arises from the sensation of the needle entering the affected area and the burning sensation induced by the corticosteroid solution.

In response to this concern, orthopaedic providers have turned to freeze sprays (Ethyl chloride), which are topical anesthetics that rapidly cool the skin and underlying tissues. By numbing the injection site superficially, freeze sprays offer the potential to mitigate patient discomfort during corticosteroid injections, thus improving the overall patient experience and potentially enhancing treatment compliance.

However, despite the popularity of freeze spray usage in orthopaedics, many orthopaedic providers have concerns about its efficacy when it comes to providing pain relief. There still needs to be comprehensive scientific evidence evaluating its efficacy and safety. A previous study evaluated the efficacy of freeze spray in hand surgery in a randomized study of 150 subjects without standardized outcomes measures. These investigators showed no difference between those receiving freeze spray vs no spray in pain or anxiety; another study of vapocoolant spray in IV start sites in the emergency department similarly showed no difference in pain or anxiety. Based on the literature, there is no definitive standard of care to use freeze spray with injections and this is the gap in knowledge we wish to answer with a rigorous, placebo-controlled study. This study will differ from the previous similar study in that the investigators will recruit double the number of patients and use standardized commonly accepted questionnaires. The use of a questionnaire based on standardized metrics will provide a more comprehensive assessment of patient perceptions and satisfaction with the use of freeze spray. Through a rigorous research approach, the investigators aim to provide valuable insights into the impact of freeze spray on patient comfort, injection success rates, and any potential complications associated with its use.

This study will contribute to the ongoing efforts of hand surgeons to refine their techniques, minimize patient discomfort, and optimize the delivery of corticosteroid injections. Ultimately, the investigators' findings may have significant implications for the broader field of musculoskeletal medicine, offering evidence-based guidance to improve the patient experience and outcomes in orthopaedic surgery.

Conditions

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Injection Fear Injection Pain Prevention Injection Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

the freeze spray group (receiving freeze spray before the injection)
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
The study will be double-blinded to minimize bias. After selection into either spray group the cans will be disguised only showing a number 1 or number 2.

Given that the freeze spray is a skin refrigerant, the saline placebo will be refrigerated to mimic the temperature on the skin. The freeze spray is odorless, as is saline, so should not pose a different in smell experience. Neither the participants or physicians will be unblinded at any point; the unblinded investigator will be the only person with access to unblinded data..

Study Groups

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Freeze spray group

Ethyl Chloride Usage Prior to Orthopaedic Injections

Group Type EXPERIMENTAL

Ethyl Chloride

Intervention Type OTHER

Topical anesthetic that rapidly cools the skin and underlying tissues

Placebo application of cold saline spray

Saline spray before injection

Group Type PLACEBO_COMPARATOR

Cold Saline Spray

Intervention Type OTHER

placebo application of cold saline spray

No spray prior to injection

No intervention before injection

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Ethyl Chloride

Topical anesthetic that rapidly cools the skin and underlying tissues

Intervention Type OTHER

Cold Saline Spray

placebo application of cold saline spray

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years and older
* Receiving a corticosteroid injection in an upper or lower extremity (to include soft tissue and joint injections) for the first time

Exclusion Criteria

* Patients with previous injection experiences
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Chicago

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University of Chicago

Chicago, Illinois, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jennifer M Wolf, MD, PhD

Role: CONTACT

773-834-3531

Jordan Swindle, MD

Role: CONTACT

Facility Contacts

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Jennifer M Wolf, MD

Role: primary

773-834-3531

Michael K Koch, Bachelor's

Role: backup

7738340822

References

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Randall DJ, Zhang Y, Li H, Hubbard JC, Kazmers NH. Establishing the Minimal Clinically Important Difference and Substantial Clinical Benefit for the Pain Visual Analog Scale in a Postoperative Hand Surgery Population. J Hand Surg Am. 2022 Jul;47(7):645-653. doi: 10.1016/j.jhsa.2022.03.009. Epub 2022 May 27.

Reference Type BACKGROUND
PMID: 35644742 (View on PubMed)

Edwards C, Noah C. A Randomized, Double-Blind Trial to Determine if Vapocoolant in the Adult Population Improves Patient Perception of Pain With Peripheral Intravascular Access. Adv Emerg Nurs J. 2017 Oct/Dec;39(4):288-294. doi: 10.1097/TME.0000000000000165.

Reference Type BACKGROUND
PMID: 29095180 (View on PubMed)

Franko OI, Stern PJ. Use and Effectiveness of Ethyl Chloride for Hand Injections. J Hand Surg Am. 2017 Mar;42(3):175-181.e1. doi: 10.1016/j.jhsa.2016.12.013.

Reference Type BACKGROUND
PMID: 28259274 (View on PubMed)

Morote Robles J, Lorente JA, Reig C, Lopez Pacios MA, de Torres JA, Soler Rosello A. [The clinical and prognostic value of inversion of the PSA/PAP ratio in prostatic cancer]. Actas Urol Esp. 1994 May;18(5):559-61. Spanish.

Reference Type BACKGROUND
PMID: 7521563 (View on PubMed)

Other Identifiers

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IRB23-2039

Identifier Type: -

Identifier Source: org_study_id

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