the purpose of this study is to evaluate the cryotherapy effect by vapocoolant spray to reducing pain during puncture for artérial blood gas

Blood gas analysis by arterial puncture is the Gold Standard in the assessment of a patient's acidbase status and oxygenation. This procedure, which can be repeated depending on the clinical condition of patient, is however associated with a potentially painful experience for patients.

The known anesthetic properties of cold can be an interesting alternative to evaluate in the reduction of pain induced during arterial puncture for gas analysis in critically il patients.

Inclusion Criteria:

• All adult patients (age≥18 years) hospitalized in Intensive Care Unit
• Patient requiering arteriale puncture for ABG
• A négative score of CAM ICU scale
• Patient with a score to visual analog scale < or equal 30mm
• Securité sociale affiliated
• consentement

Exclusion Criteria:

• patient undergoing mechanical ventilation
• patient with arterial catheter
• patient with arterio veinius fistul
• patient receiving topical anesthesic at least 2 h before the puncture
• patient with cutaneous lesion (zone of puncture)
• Raynaud Syndrom
• cold sensibility
• Allen test negative
• pregnant
• legal guardianship