Ethyl Chloride Spray to Reduce Pain From Local Anesthesia During Mohs Micrographic Surgery
NCT ID: NCT06920381
Last Updated: 2025-09-18
Study Results
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Basic Information
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RECRUITING
EARLY_PHASE1
80 participants
INTERVENTIONAL
2025-06-01
2026-06-01
Brief Summary
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Ethyl chloride is gaining popularity among dermatologists for its routine use in clinical practice due to its anesthetic and antiseptic properties, especially as a pre-injection agent. Research indicates that cryotherapy or pre-cooling the skin before administering a local anesthetic may offer benefits over topical anesthetics, such as enhanced pain relief, quicker onset, and better patient compliance 3,4. However, to our knowledge, no studies have specifically examined the effectiveness of pre-cooling with ethyl chloride prior to Mohs micrographic surgery. To address this gap, we're conducting a trial aimed at evaluating the impact of pre-cooling with ethyl chloride on pain perception in adult patients undergoing Mohs micrographic surgery with local anesthetic injections.
The trial is a single-center, split-body study. The split-body design will involve dividing the surgical site into two equal halves, with one half (right side relative to patient) designated as the treatment side (receiving ethyl chloride spray prior to lidocaine injection) and the other as the control side (no ethyl chloride spray prior to injection). During the procedure, the participant will be asked to rate the pain associated with the needle injection AND the pain from infiltration of anesthetic from each side of the wound using the visual analog scale (VAS) scoring system (1 = no pain, 10 = most amount of pain possible). The results of the study will help us better understand how to mitigate pain and anxiety for patients requiring MMS.
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Detailed Description
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Conditions
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Study Design
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NON_RANDOMIZED
CROSSOVER
TREATMENT
NONE
Study Groups
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Ethyl Chloride Spray
Prior to injection of lidocaine, the investigator will apply ethyl chloride spray, Gebauer's Ethyl Chloride Topical Spray, to the right side of the tumor lesion.
This procedure will be performed for all patients participating in the trial.
Gebauer's Ethyl Chloride Topical Spray
Prior to injection of lidocaine, the investigator will apply ethyl chloride spray, Gebauer's Ethyl Chloride Topical Spray, continuously for 4 to 10 seconds until the skin turns white. This application will be done from a distance of 8 to 18 cm (3 to 7 inches) to the right side of the tumor lesion.
Control
The investigator will perform no intervention and will continue with the normal standard of care for injecting lidocaine into the left side of the tumor lesion.
This procedure will be performed for all patients participating in the trial.
No interventions assigned to this group
Interventions
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Gebauer's Ethyl Chloride Topical Spray
Prior to injection of lidocaine, the investigator will apply ethyl chloride spray, Gebauer's Ethyl Chloride Topical Spray, continuously for 4 to 10 seconds until the skin turns white. This application will be done from a distance of 8 to 18 cm (3 to 7 inches) to the right side of the tumor lesion.
Eligibility Criteria
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Inclusion Criteria
* Pre-op tumor size at least 1.5 cm (measured on day of procedure)
Exclusion Criteria
* Anxiolytic medication within past 4 hours
* Treatment sites around the eyes
* Pre-op tumor size smaller than 1.5 cm (measured on day of procedure)
18 Years
ALL
No
Sponsors
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University of California, Davis
OTHER
Responsible Party
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Locations
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UC Davis Dermatology
Sacramento, California, United States
Countries
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Central Contacts
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Facility Contacts
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Salsala Nasim, BS
Role: primary
Daniel Eisen, MD
Role: backup
References
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Hamilton JG. Needle phobia: a neglected diagnosis. J Fam Pract. 1995 Aug;41(2):169-75.
Abbasi H, Ali F, Aslam H, Khan MS, Waqas M, Lal A. Cryoanesthesia with ethyl chloride spray versus 5% lidocaine gel in alleviating oral local anesthetic injection pain for buccal anaesthesia: A randomized clinical (controlled) trial. J Dent Res Dent Clin Dent Prospects. 2023 Winter;17(1):40-46. doi: 10.34172/joddd.2023.37041. Epub 2023 Apr 3.
Irkoren S, Ozkan HS, Karaca H. A Clinical Comparison of EMLA Cream and Ethyl Chloride Spray Application for Pain Relief of Forehead Botulinum Toxin Injection. Ann Plast Surg. 2015 Sep;75(3):272-4. doi: 10.1097/SAP.0000000000000121.
Flynn A, Barry R. Use of Ethyl Chloride in Dermatology Minor Surgery. Dermatol Surg. 2016 Mar;42(3):433-4. doi: 10.1097/DSS.0000000000000623. No abstract available.
Beroukhim K, Goldberg LH, Tarantino IS, Kimyai-Asadi A. The effect of intraoperative pain on patient satisfaction during Mohs micrographic surgery. J Am Acad Dermatol. 2022 Oct;87(4):848-849. doi: 10.1016/j.jaad.2021.10.025. Epub 2021 Oct 22. No abstract available.
Henke J, Immaneni S, Blalock T. Measuring pain and anxiety surrounding local anesthesia in Mohs micrographic surgery: A continuous and repeated-measure pilot study. J Am Acad Dermatol. 2023 Dec;89(6):1298-1300. doi: 10.1016/j.jaad.2023.08.039. Epub 2023 Aug 23. No abstract available.
Cooper DD, Seupaul RA. Does buffered lidocaine decrease the pain of local infiltration? Ann Emerg Med. 2012 Apr;59(4):281-2. doi: 10.1016/j.annemergmed.2011.05.025. Epub 2011 Aug 6. No abstract available.
Shilpapriya M, Jayanthi M, Reddy VN, Sakthivel R, Selvaraju G, Vijayakumar P. Effectiveness of new vibration delivery system on pain associated with injection of local anesthesia in children. J Indian Soc Pedod Prev Dent. 2015 Jul-Sep;33(3):173-6. doi: 10.4103/0970-4388.160343.
Other Identifiers
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2251013
Identifier Type: -
Identifier Source: org_study_id
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