Efficacy of the ShotBlocker Device versus Vapocoolant Spray for Reducing Spinal Needle Insertion Pain during Spinal Anaesthesia for Elective Caesarean Section: A Randomised Controlled Study

Introduction: Fear of needle pain during Spinal Anaesthesia (SA) is a common concern among parturients. Non pharmacological, drug-free adjuncts such as the ShotBlocker device and vapocoolant spray have been proposed to attenuate spinal needle-puncture pain, but head-to-head comparative evidence in obstetric patients remains limited. Aim: To compare the efficacy of the ShotBlocker device and vapocoolant spray with a local infiltration control in reducing spinal needle-associated pain in primigravidae undergoing elective Lower-Segment Caesarean Section (LSCS). Materials and Methods: This randomised controlled study was conducted in a tertiary-care teaching hospital from December 2025 to July 2026 after ethics committee approval. A total of 90 full-term primigravidae {American Society of Anaesthesiologists (ASA) I-II} scheduled for elective LSCS under SA were randomised equally into three groups (n=30 each): Group SB (ShotBlocker), Group V (vapocoolant spray) and Group C (local infiltration with 1 mL of 2% lignocaine). The primary outcome was needle-associated pain assessed with a 10-point Visual Analogue Scale (VAS). Secondary outcomes were patient satisfaction (3-point Likert scale), number of spinal attempts and adverse reactions. Pain scores were analysed with the Kruskal-Wallis test and categorical variables with the Chisquare test; p-value <0.05 was considered significant. Results: The three groups were demographically comparable, with no significant difference in age, weight, height, Body Mass Index (BMI), or baseline haemodynamic parameters (p-value >0.05). Mean VAS pain scores differed significantly across groups (Kruskal-Wallis p-value <0.001): Group V recorded the lowest score (2.80±0.71), followed by Group SB (3.83±0.70), both significantly lower than Group C (5.30±0.84); all pairwise comparisons were significant (p-value <0.01). On the Likert scale, 73.3% of patients in Group V reported satisfaction compared with 16.7% in Group SB, whereas 70.0% in Group C were dissatisfied (p-value <0.001). Mild local redness occurred in 36.7% of Group SB but in none of Groups V or C. Conclusion: Both the ShotBlocker device and vapocoolant spray significantly reduced spinal needle–associated pain compared with local infiltration in primigravidae undergoing elective LSCS. The vapocoolant spray provided greater pain relief and higher patient satisfaction than the ShotBlocker device and may be preferred as a simple, drug-free adjunct.