Effective Pain Reduction for Multiple Immunization Injections in Young Infants

Reis, Evelyn Cohen; Roth, Erika Kraus; Syphan, Janet L.; Tarbell, Sally E.; Holubkov, Richard

doi:10.1001/archpedi.157.11.1115

Cited by 81 publications

(71 citation statements)

References 29 publications

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“…51,52 Providers should address specific parental questions about the production and composition of the vaccines by directly providing the information requested. For example, for concerns about the presence of mercury (thimerosal) in vaccines, parents can be reassured that currently, none of the single-dose vaccine preparations given to infants contain any mercury.…”

Section: Figurementioning

confidence: 99%

Countering Vaccine Hesitancy

Edwards¹,

Hackell²

2016

Pediatrics

276

162

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Immunizations have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about addressing parental concerns about vaccination.

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Section: Figurementioning

confidence: 99%

Countering Vaccine Hesitancy

Edwards¹,

Hackell²

2016

Pediatrics

276

162

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“…Sucrose water (12%-50%; typically 1 packet of sugar in 10 mL of water) given immediately before an acute painful procedure has been shown to decrease pain in neonates and infants up to ϳ4 to 6 months of age. 57,73,74 Results from a systematic review of the literature support using sucrose to provide pain relief to infants undergoing venous access. 75 As for the mechanism, some have suggested that sucrose works via the activation of endogenous opioids, 76 although others have not found support for this hypothesis.…”

Section: Interventions For Young Infantsmentioning

confidence: 99%

Behavioral Approaches to Anxiety and Pain Management for Pediatric Venous Access

2008

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Pediatric venous access causes unnecessary anxiety and pain in children and, in turn, can have detrimental consequences. Behavioral approaches to pediatric venous access distress management can be organized temporally. Specifically, preparation before the procedure includes providing children with sensory and procedural information in an age-appropriate manner and providing training in coping skills. It is important to consider the timing, format, and content of the approach to provide optimal preparation for the unique circumstances of the individual patient. In addition to the child patient, preparing parents and teaching them which specific behaviors might be most helpful to their child should prove valuable to both patient and parents. During the procedure, there are benefits to providing secure and comfortable positioning. In addition, researchers recommend that adults encourage children to cope and actively engage children in distracting activities. For infants, there is support for the distress-mitigation properties of swaddling, skin-to-skin contact, breastfeeding, and sucrose. After venous access, distraction and encouragement of coping should speed recovery. In sum, research in behavioral approaches to pediatric pain management has provided recommendations for minimizing children's anxiety and pain associated with venous access. Pediatrics 2008;122:S134-S139 P EDIATRIC PAIN FROM medical procedures results in short-term suffering, but there are recent data to indicate that there are also long-term detrimental effects. Specifically, early painful insults might have lasting negative effects on neuronal development, pain threshold and sensitivity, coping strategies, emotionality, and pain perceptions. 1,2 As an example, Bijttebier and Vertommen 3 showed that children with a history of negative medical experiences showed high anxiety before venipuncture and were distressed and uncooperative during the procedure. Childhood medical pain has also been linked to later adulthood fear, pain, and avoidance of medical care. 4 In addition, high pain at medical visits predicts missed future medical appointments and poor health care follow-up. [5][6][7] Fortunately, there is a rich body of data supporting behavioral strategies that mitigate the anxiety and pain associated with pediatric medical procedures generally, 8 and children's needle-related pain in particular. 9 Nonpharmacologic or behavioral approaches to acute pediatric pain are rooted in the gate-control theory. 10,11 The theory suggests that descending nerve impulses from the brain, such as thoughts, beliefs, emotions, and attention, can influence the ascending pain signal from the tissue damage. For example, anxiety might heighten pain experience, whereas attention focused on a pleasant activity might decrease pain. Thus, behavioral interventions typically involve teaching coping, inducing relaxation, or providing distraction. Although literature documenting the efficacy of behavioral interventions for children's acute medical pain exists, the data...

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“…The routine vaccine injections are some of the most common and most painful procedures during childhood especially when they are administered without adopting any pain management practice² , ³. Uncontrolled pain experience in early period of life has a negative and long lasting effect such as distress 4,5 and can negatively affect the development of central nervous system [6][7][8] . Moreover fear and avoidance of medical care during adulthood are partially related to experiences of many painful procedures and fears experienced during childhood.…”

Section: Introductionmentioning

confidence: 99%

“…Swaddling, holding, and providing the oral tactile stimulation of sucking on a pacifi er are effective non-pharmacologic approaches¹º -¹ 4 . Oral sucrose is an effective pharmacologic analgesic that acts via endogenous opioid pathways [15][16][17][18][19][20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Distraction Technique During Immunization to Reduce Behaviour Response Score (FLACC) to Pain in Toddlers

Gedam

Verma

Patel

et al. 2013

J. Nepal Paedtr. Soc.

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Introduction: Distraction techniques are important non pharmacological tools to reduce pain in infants and children. Few data are available regarding their effectiveness in toddlers. We have assessed effectiveness of audio-visual distraction techniques in toddlers during and after vaccination. Materials and Methods: The study used a quasi experimental three group pretest post test design. For all the three groups, the injections were administered by same staff nurse. Group- 1 (120 Patient) was encouraged to see and play with light and sound producing toy. Group- 2 (120 Patient) children were encouraged to see cartoon movie and children of control group- 3 (110 patient) were immunized without any distraction technique. A question form was used to determine the infant’s characteristics and the Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale was used to assess the level of pain. Data was collected between 1st April 2012 and 30th September 2012. Results: The mean pain score of test group during procedure (Group-1: 2.30 & Group-2: 3.65) were lower than the score of control group (Group-3: 5.30). Similarly after procedure Score (Group-1: 4.62 & Group-2: 2.79) were lower than the score of control group (Group-3: 6.20). Conclusion: The lower pain score in response to vaccination in test group indicates that distraction technique i.e. light & sound producing toys and cartoon movies are practical way to reduce pain during routine medical interventions in toddler. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7017 J Nepal Paediatr Soc. 2013;33(1):25-30

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Effective Pain Reduction for Multiple Immunization Injections in Young Infants

Cited by 81 publications

References 29 publications

Countering Vaccine Hesitancy

Countering Vaccine Hesitancy

Behavioral Approaches to Anxiety and Pain Management for Pediatric Venous Access

Effect of Distraction Technique During Immunization to Reduce Behaviour Response Score (FLACC) to Pain in Toddlers

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