Lidocaine-prilocaine patch decreases the pain associated with the subcutaneous administration of measles-mumps-rubella vaccine but does not adversely affect the antibody response

Halperin, Scott A.; McGrath, Patrick J.; Smith, Bruce R.; Houston, Tricia

doi:10.1016/s0022-3476(00)64169-0

Cited by 52 publications

(19 citation statements)

References 26 publications

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“…However, a study in 388 children undergoing BCG vaccination found no evidence for an adverse effect of EMLA 1 on vaccination response (30). Similar results have been reported for the use of EMLA 1 with subcutaneous measles, mumps and rubella (MMR) vaccination (18) and for intramuscular DTaP-IPV-Hib plus HB vaccination (17). Thus, in deciding to use EMLA 1 , the pain-reducing bene ts do not have to be weighed against any potentially negative effects on vaccination ef cacy.…”

Section: Discussionsupporting

confidence: 78%

“…EMLA 1 effectively reduces pain in adults during injection associated with vaccination (13). EMLA 1 also effectively reduces pain behaviors of infants during intramuscular and subcutaneous injections (14)(15)(16)(17)(18). Despite the evidence in adults and infants to support the use of the anaesthetic cream for injections, no research has been undertaken to evaluate the use of EMLA 1 in managing preschool-aged children's pain during intramuscular vaccinations.…”

mentioning

confidence: 99%

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A randomized double‐blind, placebo‐controlled trial of the EMLA® patch for the reduction of pain associated with intramuscular injection in four to six‐year‐old children

et al. 2001

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 99%

A randomized double‐blind, placebo‐controlled trial of the EMLA® patch for the reduction of pain associated with intramuscular injection in four to six‐year‐old children

et al. 2001

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“…Thus, diagnostic or therapeutic acts, such as venous punctures, lumbar punctures, radial artery cannulation and vaccination are often preceded, both in children and adults, by topic anesthetic application of EMLA® (Eutectic Mixture of Local Anesthetics) cream, containing lidocaine and prilocaine (AstraZeneca Laboratories, Rueil-Malmaison, France) 9,10,11,12,13,14,15,16,17,18,19…”

Section: Introductionmentioning

confidence: 99%

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Couto

Silva

Ferreira

et al. 2014

Allergy Asthma Immunol Res

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The use of topical anesthesia to perform intradermal tests (IDTs) for drug allergy diagnosis was never investigated. We aimed to determine the effects of a topical anesthetic patch containing prilocaine-lidocaine on wheal size of IDT with drugs. Patients who had positive IDT as part of their investigation process of suspected drug hypersensitivity were selected. IDT were performed according to guidelines. Anesthetic patch (AP) was placed and the same prior positive IDT, as well as positive histamine skin prick test (SPT) and negative (saline IDT) controls, were performed in the anesthetized area. Patients with negative IDT were also included to check for false positives with AP. Increase in wheals after 20 minutes both with and without AP was recorded and compared. 45 IDT were performed (36 patients), of which 37 have been previously positive (14 antibiotics, 10 general anesthetics, 6 non-steroidal anti-inflammatory drugs, 3 iodinated contrasts, 3 anti-Hi-histamines and 1 ranitidine). Mean histamine SPT size without the AP was 4.7 mm [95%CI (4.4-5.1]), and 4.6 mm [95%CI(4.2-5.0)] with anesthesia. Mean wheal increase in IDT for drugs without the anesthesia was 4.5 mm [95%CI(3.3-5.7)] and with anesthesia was 4.3 mm [95%CI(2.8-5.8)]. No statistical significant differences were observed between skin tests with or without AP for histamine SPT (P=0.089), IDT with saline (P=0.750), and IDT with drugs (P=0.995). None of the patients with negative IDT showed positivity with the AP, or vice-versa. The use of an AP containing prilocaine-lidocaine does not interfere with IDT to diagnose drug allergy, and no false positive tests were found.

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“…Although there are many studies on pain during vaccination in children,3–6 there are few studies focusing on the adult population,7,8 possibly because pain and fear of injection are presumed to be less intense in adults 3. These studies show that pain during vaccination can be decreased by the use of analgesic drugs 4,5. In addition, different types of physical interventions6 have been developed to decrease pain during injection.…”

Section: Introductionmentioning

confidence: 99%

Analgesia for pain during subcutaneous injection: effectiveness of manual pressure application before injection

Nakashima¹,

Harada²,

Okayama³

et al. 2013

IJGM

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BackgroundIt is necessary to establish an effective subcutaneous injection procedure for adult and elderly individuals because many drugs such as hormones and interferon are generally delivered by subcutaneous injection. We tested whether pain during subcutaneous injection can be decreased by prior application of localized manual pressure at the injection site.MethodsIn this semirandomized, open-label study evaluating the manual pressure method for transient analgesia, physicians applied pressure with their thumbs for 10 seconds to create a nonpainful skin depression at the injection site immediately before subcutaneous injection of the influenza vaccine to patients. Control patients received the vaccine by the same route, but without prior application of focal pressure. In addition to pain, we evaluated patient age, gender, height, weight, body mass index, body temperature, and fat thickness at the brachial triceps muscle. Pain intensity was estimated using a 100 mm visual analog scale (VAS) and the face scale (FS). Categorical variables were compared using Chi-square tests and continuous variables were compared using unpaired t-tests between the intervention group and control group. Multivariate analysis was performed using the VAS or FS score as the dependent variable and weight, age, height, fat thickness at the brachial triceps muscle, and body temperature as independent variables.ResultsThere were no significant differences in demographic variables, VAS scores (22.5 ± 23.0 versus 21.2 ± 23.6, P = 0.4), or FS scores (2.5 ± 2.1 versus 2.4 ± 2.1, P = 0.4) between the intervention and control groups. There was a significant negative correlation between age and subjective pain intensity (VAS, r = −0.32; FS, r = −0.28).ConclusionThe manual pressure method was not effective in decreasing pain during subcutaneous injection. Alternative methods of focal transient analgesia should be developed to improve vaccination rates and relieve anxiety associated with subcutaneous injection.

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Lidocaine-prilocaine patch decreases the pain associated with the subcutaneous administration of measles-mumps-rubella vaccine but does not adversely affect the antibody response

Cited by 52 publications

References 26 publications

A randomized double‐blind, placebo‐controlled trial of the EMLA® patch for the reduction of pain associated with intramuscular injection in four to six‐year‐old children

A randomized double‐blind, placebo‐controlled trial of the EMLA® patch for the reduction of pain associated with intramuscular injection in four to six‐year‐old children

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Analgesia for pain during subcutaneous injection: effectiveness of manual pressure application before injection

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