The use of a topical refrigerant anesthetic to reduce injection pain in children

Abbott, Karen; Fowler‐Kerry, Susan

doi:10.1016/0885-3924(95)00086-0

Cited by 60 publications

(53 citation statements)

References 23 publications

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“…This is especially noteworthy since evidence from the small number of pediatric clinical trials studies suggests that PR might be even more pronounced in children compared to adults (6)(7)(8). Clinical trials of local anesthetics (9,10) as well as a venipuncture study (11) emphasize the significance of PR in children. From a neurobiological perspective this is even more interesting since the prefrontal cortex (PFC) has repeatedly been implicated in the mediation of cognitive top-down expectation-related PR (12)(13)(14)(15) and given that this neural network undergoes considerable maturation during childhood (16,17).…”

Section: Introductionmentioning

confidence: 99%

Expectancy-Induced Placebo Analgesia in Children and the Role of Magical Thinking

Kempler

Kossowsky

Schwarz

et al. 2014

The Journal of Pain

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Expectations and beliefs shape the experience of pain. This is most evident in context-induced, placebo analgesia, which has recently been shown to interact with the trait of magical thinking (MT) in adults. In children, placebo analgesia and the possible roles that MT and gender might play as modulators of placebo analgesia have remained unexplored. Using a paradigm in which heat-pain stimuli were applied to both forearms, we investigated whether MT and gender can influence the magnitude of placebo analgesia in children. Participants were 49 right-handed children (aged 6-9 years) who were randomly assigned -stratified for MT and gender -to either an analgesia-expectation or a controlexpectation condition. For both conditions, the placebo was a blue-colored hand disinfectant that was applied to the children's forearms. Independent of MT, the placebo treatment significantly increased both heat pain threshold and tolerance. The threshold placebo effect was more pronounced for girls than boys. In addition, independent of the expectation treatment, low-MT boys showed a lower tolerance increase on the left compared to the right side. Finally, MT specifically modulated tolerance on the right forearmside: low-MT boys showed an increase, whereas high-MT boys showed a decrease in heat pain tolerance. This study documented a substantial expectation-induced placebo analgesia response in children (girls > boys) and demonstrated MT and gender-dependent laterality effects in pain perception. The findings may help improve individualized pain management for children. PERSPECTIVE: The study documents the first experimental evidence for a substantial expectancy-induced placebo analgesia response in healthy children from 6 to 9 years of age. Moreover, the effect was substantially higher than the placebo response typically found in adults. The findings may help improve individualized pain management for children. Conflicts of Interest and Source of FundingThe authors declare that there is no conflict of interest. This research was supported by the University of Basel.Running Title: Placebo Analgesia and Magical Thinking in Children Krummenacher et al., 2014 1 Abstract Objective: Higher brain functions such as expectations and beliefs shape the experience of pain. This is most evident in context-induced placebo analgesia (PA), which was recently shown in adults to interact with the trait of magical thinking (MT).In children, PA and the possible relationship between PA and MT has remained unexplored.Methods: Using a lateralized heat-pain paradigm, we investigated the possible modulatory role of PA expectation and MT in response to nociceptive stimuli on the right and left forearm.Participants were 49 right-handed children (6-9 years). In a between-subjects design, half of them were either randomly -stratified for MT and gender -assigned to an analgesia-expectation or a control-expectation condition. Results:Results indicate that, independent of MT, the placebo procedure significantly increased both heat pain threshold (...

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Section: Introductionmentioning

confidence: 99%

Expectancy-Induced Placebo Analgesia in Children and the Role of Magical Thinking

Kempler

Kossowsky

Schwarz

et al. 2014

The Journal of Pain

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“…15 Two studies compared the effectiveness of vapocoolant spray with a placebo in reducing vaccination pain. 15,17 Cohen et al 17 17 The analysis of the CAMPIS and VAS scoring did not find significant support for vapocoolant in reducing vaccination pain. However, the sample size (n=57) was insufficient to accurately identify any differences between the treatment and placebo groups.…”

Section: Topical Anestheticsmentioning

confidence: 99%

“…[15][16][17][18][19] Vapocoolant and lidocaine-prilocaine cream (5% eutectic emulsion of lidocaine [25 mg/g] and prilocaine [25 mg/g]) are both topical anesthetics approved for pain reduction during pediatric procedures, such as vaccinations. The studies investigated the effectiveness of these topical anesthetics.…”

Section: Topical Anestheticsmentioning

confidence: 99%

Minimizing pain during childhood vaccination injections: improving adherence to vaccination schedules

Eden¹,

Macintosh²,

Luthy³

et al. 2014

PHMT

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Pain experienced in childhood can lead to long-term and psychologically detrimental effects. Unfortunately, the most common pain experienced in childhood is caused by vaccinations and may lead to non-adherence to the recommended vaccination schedule. As a result, it is the health care provider's responsibility to take measures to reduce vaccination pain; however, there are a plethora of pain relieving interventions during immunizations and it is unclear which interventions are most cost efficient, timely, and effective. Studies have been conducted to investigate the efficacy of different pain management interventions during vaccinations. This review evaluates various pain relieving interventions and provide health care providers age appropriate guidance on pain relieving interventions during vaccinations. Employment of these strategies may successfully reduce vaccination-associated pain in infants, children, and adolescents, and may improve compliance with the vaccination schedule.

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“…Other studies have shown that the use of cryoanalgesic sprays can be helpful in assuring adherence to proper vaccination scheduling in the pediatric population (2,3). Studies document that the use of refrigerant spray can significantly reduce injection pain, making the office experience less objectionable and compliance more likely (2)(3)(4). Vapocoolant sprays have also been used to manage myofascial trigger points and to lessen the pain of analgesic injection for dental procedures (5).…”

mentioning

confidence: 99%

Microcirculatory effect of topical vapocoolants

et al. 2015

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The use of a topical refrigerant anesthetic to reduce injection pain in children

Cited by 60 publications

References 23 publications

Expectancy-Induced Placebo Analgesia in Children and the Role of Magical Thinking

Expectancy-Induced Placebo Analgesia in Children and the Role of Magical Thinking

Minimizing pain during childhood vaccination injections: improving adherence to vaccination schedules

Microcirculatory effect of topical vapocoolants

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