No pain, much to gain!!
Abstract
Background: Vaccination is an integral aspect of a pediatrician's practice. The fear associated with pain is a common problem. Alleviating this pain, not only puts the child at ease but also reduces the apprehension some parents have. Our objective was to evaluate local analgesic use during childhood immunization, its efficacy, and assessing how it serves as an advantage to the patient, the parents/guardian, and the medical personnel.
Methodology: It was a randomized study. Data was collected for a period of 1 year, from August 2018 to August 2019. Children from birth to 18 years were divided into 2 groups: case (local anesthetic i.e Lidocaine aerosol applied) and control (no local anesthetics applied). They were immunized as per NIS/IAP. The pain was assessed by a standard pain chart (Modified Behavioural Pain Scale (BPS).
Result: Totally (including IM, SC, and ID injections), the Local anesthesia group Median pain score was 6 and the No Local anesthesia group Median pain score was 8. There was a significant difference in pain scores between the two groups.
Conclusion: The present study showed that local anesthetics could be applied quickly and with ease. There was a significant difference in pain scores between the two groups (higher score being in the group in which local anesthetics weren’t used). The reduction in the pain score, in turn, showed a significant difference in the attitude of the child, parent, as well as medical personnel.
Downloads
References
Ten Great Public Health Achievements -- United States, 1900-1999 [Internet]. Cdc.gov. 2020 [cited 3 September 2020]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm
IAP guidebook on immunization 2018-2019. 3rd ed. New Delhi: JAYPEE Brothers MEDICAL P; 2019.
Home - Wong-Baker FACES Foundation [Internet]. Wong-Baker FACES Foundation. 2020 [cited 3 September 2020]. Available from: https://wongbakerfaces.org/
Crellin D, Babl F, Santamaria N, Harrison D. The Psychometric Properties of the MBPS Scale Used to Assess Procedural Pain. The Journal of Pain. 2018;19(6):660-669. doi: 10.1016/j.jpain.2018.01.012.
The countries that trust vaccines the least [Internet]. BBC News. 2020 [cited 3 September 2020]. Available from: https://www.bbc.com/news/health-48512923.
Kids C. Vaccines: Common concerns - Caring for Kids [Internet]. Caringforkids.cps.ca. 2020 [cited 3 September 2020]. Available from: https://www.caringforkids.cps.ca/handouts/vaccines-common-concerns.
(COVID-19) C, Health E, Disease H, Disease L, Management P, Conditions S et al. Immunizations and Vaccines [Internet]. WebMD. 2020 [cited 3 September 2020]. Available from: https://www.webmd.com/children/vaccines/immunizations-vaccines-power-of-preparation#3.
Schechter N, Zempsky W, Cohen L, McGrath P, McMurtry C, Bright N. Pain Reduction During Pediatric Immunizations: Evidence-Based Review and Recommendations. Pediatr. 2007;119(5):e1184-e1198. doi: 10.1542/peds.2006-1107.
Halperin BA, Halperin SA, McGrath P, Smith B, Houston T. Use of lidocaine-prilocaine patch to decrease intramuscular injection pain does not adversely affect the antibody response to diphtheria- tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b conjugate and hepatitis B vaccines in infants from birth to six months of age. Pediatr Infect Dis J. 2002 May;21(5):399- 405. doi: 10.1097/00006454-200205000-00010.
Halperin SA, McGrath P, Smith B, Houston T. Lidocaine-prilocaine patch decreases the pain associated with the subcutaneous administration of measles-mumps-rubella vaccine but does not adversely affect the antibody response. J Pediatr. 2000;136(6):789-794.
Taddio A, Manley J, Potash L, Ipp M, Sgro M, Shah V. Routine Immunization Practices: Use of Topical Anesthetics and Oral Analgesics. Pediatr. 2007;120(3):e637-e643. doi: 10.1542/peds.2006-3351.
Hogan ME, Kikuta A, Taddio A. A systematic review of measures for reducing injection pain during adult immunization. Vaccine. 2010;28(6):1514-1521.
Shah V, Taddio A, Rieder M. Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood immunizations: Systematic review and meta-analyses. Clinical Therapeutics. 2009;31:S104-S151. doi: 10.1016/j.clinthera.2009.08.001.
Abuelkheir M, Alsourani D, Al-Eyadhy A, Temsah M, Meo S, Alzamil F. EMLA® cream: A pain-relieving strategy for childhood vaccination. J Int Med Res. 2014;42(2):329-336. doi: 10.1177/0300060513509473.
Zhu J, Liu J, Shen G, Zhong T, Yu X. Comparison of Efficacy Outcomes of Lidocaine Spray, Topical Lidocaine Injection, and Lidocaine General Anesthesia in Nasal Bone Fractures Surgeries: A Randomized, Controlled Trial. Med Sci Monit. 2018;24:4386-4394. doi: 10.12659/MSM.908468.
Cohen Reis E, Holubkov R. Vapocoolant Spray Is Equally Effective as EMLA Cream in Reducing Immunization Pain in School-aged Children. Pediatr. 1997;100(6):e5-e5. doi: 10.1542/peds.100.6.e5.
Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
