A randomized controlled trial of vapocoolant for pediatric immunization distress relief

Clin J Pain. 2009 Jul-Aug;25(6):490-4. doi: 10.1097/AJP.0b013e3181a00414.


Objectives: The purpose of this study was to evaluate the effectiveness of vapocoolant for preschoolers' immunization injection pain relief.

Methods: Fifty-seven 4 to 6-year-old children were randomized into vapocoolant alone or typical care conditions. Pain was measured at the baseline and at injection via self-report, caregiver report, nurse report, and by an observational scale.

Results: Self-report of pain suggested that children in the vapocoolant alone condition demonstrated stronger increases in pain from baseline to injection than children in the typical care condition. All other measures showed significant increases in pain from baseline to injection, but no other measures indicated treatment effects.

Discussion: This study revealed that vapocoolant is not an effective pain management intervention for children's intramuscular injections.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use*
  • Child
  • Child, Preschool
  • Ethyl Chloride / administration & dosage
  • Ethyl Chloride / therapeutic use*
  • Female
  • Humans
  • Immunization / adverse effects*
  • Male
  • Pain / drug therapy*
  • Pain / etiology*
  • Pain / psychology
  • Pain Measurement


  • Anesthetics, Local
  • Ethyl Chloride