• Loren G Yamamoto, Jason T Nomura, Renee L Sato, Reina M Ahern, Joanne L Snow, and Todd T Kuwaye.
• Emergency Department, Kapiolani Medical Center For Women And Children, and Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA. Loreny@hawaii.edu
• Am J Emerg Med. 2003 May 1; 21 (3): 176-9.

AbstractWe conducted two studies to determine whether the minimum clinically significant difference in the visual analog scale (VAS) for nearly simultaneous and brief-interval serial assessments of pain is less than that for pain assessment at 20- to 30-minute intervals, using a 10-cm VAS. The first study was a blinded, randomized, placebo-controlled paired trial comparing the pain of intravenous cannulation in both hands (20-minute application of a eutectic mixture of local anesthetics v placebo) of study subjects. The second study was a non-blinded, randomized, paired trial of different treatments for jellyfish stings. In the first study, 37 of 40 subjects indicated that one hand experienced more pain than the other. Eleven of these 37 subjects (30%) indicated differences in VAS values of 1.0 cm or less, with a minimum value of 0.5 cm. In the second study, for all the VAS-based pain comparisons, VAS differences of

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