The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain

Abstract

Background:Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous systemObjectives:The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain.Patients and Methods:Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group.Results:Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005).Conclusions:The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns.

Vaccinology Education of Nurses and the Current Immunoprophylaxis Recommendations for Children with Juvenile Idiopathic Arthritis

“…If this is the case, the nurse should consult the doctor and agree on an alternative injection site. It should also be noted that the proper technique of administration allows obtaining the desired immunoprophylactic results [46,47].…”

Hepatitis Vaccines

“…The schedules also differ among countries and sub-populations. There are also separate recommendations for preterm infants and a caution that topical administration of EMLA cream should be done prior to administration of HBV vaccine in this population [ 25 ] to minimize the pain associated with the vaccine in these infants. It should also be noted that HBV vaccination is equally efficacious in non-infected infants, children, and adults.…”

Cuidados na aplicação de vacinas parenterais baseado em evidências: desenvolvimento de um guia para profissionais de saúde

“…Além disso, uma RI sobre o uso da técnica em Z mostrou que há escassez e limitações nos estudos sobre a técnica e alto risco de viés na maioria dos ensaios clínicos randomizados avaliados. (42) Um dos especialistas sugeriu suprimir algumas estratégias para alívio da dor (estímulo tátil como Helfer Skin Tap (43) e anestésicos locais (44) argumentando que tais estratégias não são recomendadas nos manuais brasileiros oficiais. Contudo, optamos por manter no Guia por se tratar de estratégias descritas em estudos da literatura internacional, escopo da revisão de literatura utilizada na construção desse Guia.…”