Comparisons of ice packs, hot water immersion, and analgesia injection for the treatment of centipede envenomations in Taiwan

Objective. To compare the effectiveness of ice packs and hot water immersion for the treatment of centipede envenomations. Methods. Sixty patients envenomated by centipedes were randomized into three groups and were treated with ice packs, hot water immersion, or analgesia injection. The visual analog score (VAS) for pain was measured before the treatment and 15 min afterward. Demographic data and data on local and systemic effects after centipede bites were collected. The VAS scores and the pain decrease (Delta VAS) were compared between the three groups. Results. All patients suffered from pain at the affected sites; other local effects included redness (n = 49, 81.7%), swelling (n = 32, 53.3%), heat (n = 14, 23.3%), itchiness (n = 5, 8.3), and bullae formation (n = 3, 5.0%). Rare systemic effects were reported. All three groups had similar VAS scores before and after treatment. They also had similar effectiveness in reducing pain caused by centipedes bites (Delta VAS = 2.55 +/- 1.88, 2.33 +/- 1.78, and 1.55 +/- 1.68, with ice packs, analgesia, and hot water immersion, respectively, p = 0.165). Conclusion. Ice packs, hot water immersion, and analgesics all improved the pain from centipede envenomation. Ice pack treatment is a safe, inexpensive, and non-invasive method for pre-hospital management in patients with centipede envenomation.