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Relative effectiveness of additive pain interventions during vaccination in infants

Anna Taddio1, Rebecca Pillai Riddell2, Moshe Ipp2

  • 1Leslie Dan Faculty of Pharmacy (Taddio, Fletcher, Wong, McNair, Mithal), University of Toronto; Child Health Evaluative Sciences (Taddio), The Hospital for Sick Children, Toronto, Ont.; Department of Psychology (Pillai Riddell), York University, North York, Ont.; Department of Psychiatry (Pillai Riddell) and Paediatrics (Ipp), University of Toronto, Toronto, Ont.; Pediatricians (Moss, Baker, Tolkin, Malini, Feerasta, Govan), North York, Ont.; Biostatistics and Data Analysis Unit (Stephens), The Hospital for Sick Children, Toronto, Ont. anna.taddio@utoronto.ca.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|December 14, 2016
PubMed

Insights

Topical liposomal lidocaine, combined with video education and sucrose, effectively reduced infant pain during vaccinations. This additive pain intervention strategy improved the vaccination experience for infants and parents.

Area of Science:

  • Pediatric Pain Management
  • Vaccination Adverse Events
  • Clinical Trial Methodology

Background:

  • Vaccine injections cause pain and distress in infants, potentially leading to vaccine hesitancy.
  • Effective pain management during infant vaccinations is crucial for a positive healthcare experience.

Purpose of the Study:

  • To compare the effectiveness of additive pain interventions during infant vaccinations.
  • To evaluate combined interventions including video education, sucrose, and topical lidocaine.

Main Methods:

  • A multicenter, double-blind, randomized controlled trial involving 352 infants.
  • Infants received one of four pain management strategies: placebo, video, video+sucrose, or video+sucrose+lidocaine.
  • Infant distress was assessed using the Modified Behavioural Pain Scale during pre-injection, injection, and recovery phases.

Main Results:

  • The combination of video, sucrose, and liposomal lidocaine showed a trend towards lower needle pain scores (6.3 ± 0.8) compared to other groups (6.7 ± 0.8).
  • No significant differences in pain scores were found between groups for baseline or recovery phases.
  • Pain scores varied significantly across infant ages, with needle pain scores differing among intervention groups (p=0.003).

Conclusions:

  • Liposomal lidocaine, as part of an additive pain intervention, provided consistent analgesia during infant vaccinations.
  • This multimodal approach may help mitigate pain and distress associated with routine infant immunizations.
Abstract

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