24 Use of Amethocaine Gel for Reducing MMR Vaccination Pain
Notice bibliographique
Résumé
Routine vaccination is the most common source of iatrogenic pain in healthy infants; the pain from this procedure has been shown to be ameliorated by the use of topical anaesthesia prior to vaccination. A novel, rapidly acting, local anaesthetic gel, Ametop™, which contains 4% amethocaine, has recently become available for clinical use. A double-blind, randomized placebo-controlled study was conducted to determine whether the use of Ametop™, decreases the pain associated with subcutaneous measles-mumps-rubella (MMR) vaccination in infants. Healthy infants receiving their routine 12-month MMR vaccination were randomized to receive 1 g of 4% amethocaine or a visually identical placebo on their deltoid muscle 30 minutes prior to vaccination. The vaccination procedure was videotaped and the Modified Behavioral Pain Scale (MBPS) was used to assess baseline and post vaccination pain scores; scores ranged from 0 (no pain) to 10 (worst possible pain) and the difference between pre and post vaccination pain scores was used as the net change in pain. One month post-vaccination antibody titers were measured to ensure that amethocaine did not interfere with the immunogenicity of the vaccine. Local skin reactions were also assessed. One hundred and twenty infants participated in the study; 60 were followed-up for assessment of antibody titers. There were no significant differences in infant demographic characteristics. The Ametop™ group (n=61) had significantly lower mean MBPS scores, than the placebo group (n=59); the net change in vaccination pain scores was 1.51 vs. 2.29 for the amethocaine and placebo groups respectively (p=0.029). The rate of vaccination success (antibody titers positive for measles, mumps and rubella) was not different between the amethocaine and placebo groups; 87% and 88% respectively (p=0.823). Overall, the amethocaine group developed significantly more local skin reactions than the placebo group, including erythema (p<0.001), pallor (p=0.014) and edema (p<0.001). All skin reactions were transient and self-limiting. Pretreatment with Ametop™ gel has been shown to significantly reduce the pain associated with subcutaneous MMR vaccination in one year old infants when compared to placebo and did not interfere with subsequent development of protective antibody levels. Further investigation of its safety during vaccination is recommended before widespread clinical use.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».