Fan-Assisted Local Cooling for Pain During Intravenous Cannulation in Adults: A Randomised Crossover Trial

Inserting an intravenous (IV) cannula is one of the most frequently performed procedures in clinical practice, and it is commonly experienced as painful. Before the needle is inserted, the skin is routinely cleaned with alcohol. As alcohol evaporates it cools the skin, and cooled skin is less sensitive to pain. This study examined whether accelerating that evaporation with a simple portable hand fan reduces the pain of IV cannulation. One hundred volunteers aged 18 to 65 years who required elective IV cannulation took part in the emergency department of a tertiary care city hospital. Each participant underwent two cannulations, one in each arm, within a single session. On one arm the skin was prepared with 70% isopropyl alcohol in the usual way. On the other arm the same alcohol was applied and the site was then fanned for 15 seconds with a portable hand fan before the needle was inserted. The order of the two arms was assigned randomly, so each participant served as their own comparison. Within 30 seconds of each cannulation, participants rated their pain on a 0 to 10 numeric scale. The assessor who recorded these scores did not know which arm had received the fan. The researchers also recorded whether the vein was entered on the first attempt, any skin irritation at 5 and 30 minutes, and, after both cannulations were completed, how satisfied participants were with the fan-assisted method. The purpose of the study was to determine whether this low-cost, drug-free method can make IV cannulation less painful without making it harder to place the cannula.

Inclusion Criteria: Aged 18 to 65 years Requiring elective intravenous cannulation of the antecubital region Provided written informed consent Exclusion Criteria: Severe peripheral vascular disease (chronic venous insufficiency, history of thrombophlebitis) Alcohol intolerance or allergy Active dermatological disease (eczema, psoriasis, contact dermatitis) Neuropathic disease that could alter pain perception Analgesic use within the past 6 hours Existing pain of NRS 4 or greater Refusal to provide consent