Air-Cooling Device Reduces Pain of Local Anesthetic Administration for Nail Surgery

Toenail surgery
Toenail surgery
The use of an air-cooling device to improve patient comfort during the local anesthetic infiltration stage of nail surgery is an alternative to any cooling method.

The use of an air-cooling device to improve patient comfort during the local anesthetic infiltration stage of nail surgery is supported by data published in the Journal of the American Academy of Dermatology.

Researchers described the results of 2 published studies of cold air as an analgesic. Patients undergoing nail surgery typically report significant discomfort during administration of the local anesthetic. Methods to mitigate the pain of infiltration include the use of a buffered or warmed anesthetic solution, slower infiltration technique, use of a different needle or injection angle, use of a vibration device, and direct cold application. Direct cold application for nail surgery can be performed using ice, cool saline bags, liquid nitrogen, or gel.

The use of an air-cooling device has emerged in literature as an effective alternative to any contact cooling method. The air-cooling device delivers a cold stream of air with a flow of 500 to 1000 L/min and can reach temperatures as low as −30°C. Compared with contact cooling, the device does not create physical interference with the treatment area and is unaffected by skin topography.

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Preliminary study data indicate that air-cooling reduces patient pain during infiltration, as well as during laser treatment. Given these advantages, investigators advocated for further study of air-cooling devices in controlled clinical trials.

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Reference

Ricardo JW, Lipner SR. Air cooling for improved analgesia during local anesthetic infiltration for nail surgery [published online November 22, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.11.032