Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial
Keywords:
lidocaine-prilocaine cream, pain, neonates
Abstract
Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairs
emotional bonding, and causes hyperalgesia. Combination of
lidocaine and prilocaine cream is one of the topical analgesics
that are easy to use and safe for neonates.
Objective To assess the efficacy of lidocaine-prilocaine
combination cream in reducing pain caused by intramuscular
injection of hepatitis B and to find out the correlation of sex,
gestational age, birth weight, chronological age, and method of
delivery with infant’s pain response.
Methods A double blind randomized controlled trial was
conducted on term neonates. Subjects were selected consecutively
and every subject was randomized to either receive lidocaine-
prilocaine cream or placebo one hour prior to administration of
intramuscular hepatitis B vaccine. The administration was
recorded by a handycam and the intensity of pain responses was
evaluated using DAN (Douleur Aigue Nouveau-ne) scale.
Results Of 67 subjects, the mean of DAN scale was 7.60 (95%
CI 7.27;7.95) in the lidocaine-prilocaine cream group and this
was significantly lower (P<0.0001) than in placebo group, which
was 8.82 (95% CI 8.56;9.09). ANCOVA showed that there were
no associations between sex, gestational age, birth weight,
chronological age, and method of delivery with infant’s pain
response.
Conclusion Lidocaine-prilocaine combination cream can reduce
the pain caused by intramuscular injection of hepatitis B vaccine
on term neonates.
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period of 2004. Cited in 2 December 2005. available from:
url: http//www.idai.or.id/web/jadwal_ imunisasi. html.
2. Porter FL, Wolf CM, Gold J, Lotsoff D, Miller JP. Pain and
pain management in newborn infants: A survey of physician
and nurses. Pediatrics 1997; 100:626-32.
3. Kandel ER, Schwartz JH, Jessel TM. Principles of neural
science. 4th edition. New York: McGraw-Hill; 2000. p.
472-91.
4. Uhari M. A eutectic mixture of lidocaine and prilocaine
for alleviating vaccination pain in infants. Pediatrics 1993;
92:917-21.
5. Bursch B, Zelter LK. Pediatric pain management. In:
Behrman RE, Kliegman RM, Jenson HB, editors. Nelson
textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004.
p. 358-66.
6. Mathew PJ, Mathew JL. Assessment and management of
pain in infants. Postgrad Med J 2003;79:438-43.
7. American Academy of Pediatrics and American Pain
Society. The assessment and management of acute pain in
infants, children and adolescent. Pediatrics 2001;108:793-7.
8. Carbajal R, Chauvet X, Coudere S, Olivier-Martin M.
Randomised trial of analgesic effects of sucrose, glucose, and
pacifier in term neonates. BMJ 2003;319:1393-7.
9. Duhn LJ, Medves JM. A Systematic Integrative Review of
Infant Pain Assessment Tools. Adv Neonatal Care
2004;4:126-40.
10. Tadio A, Stevens B, Craig K, Rastogi P, Ben-David S,
Shennan A, et al. Efficacy and safety of lidocaine-
prilocaine cream for pain during circumcision. NEJM
1997;336:1197-201.
11. PDR drug information for EMLA cream. cited 2005
November 9. available from: url:http//www.drugs. com/pdr/
Emla_cream.html.
12. Lindh V, Wilkund U, Blomquist H, Hakansson S. EMLA
cream and oral glucose for immunization pain in 3-month-
old infants. Pain 2003;104:381-8.
13. Cassidy KL, Reid GJ, McGrath PJ, Smith DJ, Brown TL,
Finley GA. 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.
Acta Paediatr 2001;90:1329-36.
14. Singh H, Singh D, Soni RK. Comparison of pain response to
venipuncture between term and preterm neonates. Indian
Paediatrics 2000;37:179-81.
15. Sheffield D, Biles PL, Orom H, Maixner W, Sheps DS. Race
and sex differences in cutaneous pain perception. Psychosom
Med;62:517-23.
16. Zempsky WT, Schechter NL. What’s new in the management
of pain in children. Pediatr Rev 2003;24:337-47.
17. Friedman MP, Mafong EA, Friedman ES, Geronemus RG.
Topical anesthetics update: EMLA and beyond. Dermatol
Surg 2001;27:1019-26.
Published
2007-02-28
How to Cite
1.
Karyadiguna N, Soetjiningsih S, Retayasa W, Kardana M. Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial. PI [Internet]. 28Feb.2007 [cited 20Apr.2024];47(1):12-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/258
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Received 2016-08-19
Accepted 2016-08-19
Published 2007-02-28
Accepted 2016-08-19
Published 2007-02-28
