Analgesic spray offers clinical benefits in pediatric patients, cost efficiency

March 1, 2010

An analgesic spray was used in 60 children scheduled to undergo lysis of glanular adhesions, lysis of labial adhesions, or excision of glanular skin bridges, and worked about 30 minutes faster than analgesic cream.

Washington-A simple analgesic spray can have a significant impact on both young patients and physicians' practices, according to a study presented at the American Academy of Pediatrics Section on Urology annual meeting.

Jeffrey S. Palmer, MD, director of the center and the study's sole author, told Urology Times the spray was "safe, fast, effective, and easy to apply. It reduces the length of time children have to stay in the office, which contributes to a less traumatic visit for the child and allows practitioners to run more efficient offices."

"I have seen no difference in effect [between the cream and spray], other than the spray allowed the patient to leave the office a lot sooner," he said.

He explained that patients do not have to endure the psychological trauma of anticipating a procedure while waiting for a topical cream to exert its full numbing influence.

To arrive at these findings, Dr. Palmer evaluated the spray in 60 children scheduled to undergo lysis of glanular adhesions, lysis of labial adhesions, or excision of glanular skin bridges. The aerosol, also known as a vapocoolant (or skin refrigerant), was applied at a distance of 3 to 7 inches from the treatment site prior to the skin turning white. The treatment lasted for the duration of the procedure, Dr. Palmer said.

Thirty-four circumcised boys aged 0.3 to 0.9 years underwent lysis for glanular adhesions and 10 circumcised boys aged 0.9 to 4.2 years underwent excision of glanular skin bridges. Sixteen girls aged 0.4 to 5.0 years underwent lysis for labial adhesions.

No complications observed

All patients tolerated the procedure and none exhibited complications such as frostbite or changes in skin pigmentation. None of the patients required post-treatment oral or topical analgesics.

Dr. Palmer also conducted a cost analysis comparing creams with the spray. According to his figures, the cost of the spray was $0.58 per procedure, compared to $4.27 per procedure with topical creams.

Dr. Palmer noted that the spray is commonly used for minor topical procedures such as IV insertions, immunizations, and treatment of minor wounds. To his knowledge, this is the first formal report of the spray being used for the particular presentations noted.

Although there is a substantial difference in the dollar cost per treatment, the bigger and more valuable savings come in terms of time efficiency and parental satisfaction, Dr. Palmer explained. The added efficiency allows patients to be seen within the time allocated for the office visit and eliminates time spent waiting for the analgesic to take effect, thus contributing to patient and parental satisfaction, he added.

Dr. Palmer said he is exploring other potential clinical applications of the spray.