Abstract:

Background: Cooling spray application is commonly used in sports injuries to manage acute pain and reduce tissue edema. However, its effectiveness in treating acute trauma in the emergency department remains understudied. This prospective randomized controlled trial assessed the efficacy of cooling spray for pain management in patients with wrist injuries. Methods: A randomized trial was conducted in a tertiary care hospital's trauma department. Patients with wrist trauma were assigned to cooling spray or placebo (saline spray) groups. Cooling spray was Cryos®Spray (Phyto Performance, Italy), while placebo was chilled saline in an identical bottle. Pain scores and radiographic images were evaluated. Results: In 131 patients (mean age: 35.60±19.58 years, 26.7% fractures), cooling spray (n=73) yielded a delta pain score of 1.74±1.88, while saline (n=58) had 0.84±1.54 (p=0.003). For fracture patients, cooling spray's delta score was 2.26±1.88, compared to saline's 0.0±0.96 (<0.001). Non-fracture patients showed similar efficacy between cooling spray (1.55±1.85) and saline (1.16±1.60, p=0.258). Logistic regression indicated cooling spray reduced pain 1.174 times more effectively than saline. Conclusions: Cooling sprays demonstrated superior acute pain control, notably in fractures, outperforming the placebo. Similar efficacy was observed in non-fracture cases.

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