24 Use of Amethocaine Gel for Reducing MMR Vaccination Pain
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".