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We have read with great interest the recently published study titled ‘Comparison of the Effects of Vapocoolant Spray and Topical Anaesthetic Cream (Lidocaine–Prilocaine) on Pain of Intravenous Cannulation: A Randomised Controlled Trial’ by Akhgar et al.1 This study addresses an important clinical issue in pain management during intravenous cannulation and provides a comparison between vapocoolant spray and lidocaine–prilocaine cream. However, we believe that certain methodological aspects and interpretations warrant further consideration.