Vaccine-related pain: randomised controlled trial of two injection techniques

Ipp, Moshe; Taddio, Anna; Sam, Jonathan; Gladbach, Morton; Parkin, Patricia C.

doi:10.1136/adc.2007.118695

Cited by 72 publications

(69 citation statements)

References 14 publications

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“…Procedure modifications, such as rapid injection and needle withdrawal (Ipp et al, 2007 Level II) and using a longer needle (Schechter et al, 2007 Level I) reduced pain associated with immunisations. Parental responses during injection such as excessive reassurance, criticism or apology increase distress, whereas humour and distraction tend to decrease distress (Schechter et al, 2007 Level I).…”

Section: Immunisation Pain In Infants and Childrenmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Immunisation Pain In Infants and Childrenmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…However, in clinical practice, observed injection speeds have been faster. 10 One RCT involving 113 infants aged four to six months 42 that was included in the systematic review 10 reported less pain for intramuscular injection via a rapid injection technique without aspiration (approximate total injection time of one second for a volume of 0.5 mL) relative to a slow injection technique with aspiration (approximate total injection time of nine seconds). We believe that these results are generalizable to all children because of similarities in the procedure and how pain is processed neurologically.…”

Section: Intramuscular Injection Techniquesmentioning

confidence: 99%

Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline

Taddio¹,

Appleton²,

Bortolussi³

et al. 2010

Canadian Medical Association Journal

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194

199

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“…Literatürde, 1 saniyede 0,5 mL ilacın enjekte edildiği ve kanın aspire edilmediği hızlı bir aşı enjeksiyonunda, iğnenin kas içinde hem daha kısa süre kalması hem de hastanın daha az kıpırdanması nedeni ile ağrı hissinin azaldığı belirtilmektedir. 19,26 Bununla birlikte, aşılar dışında yenidoğanlara verilen IM ilaçlar için ideal enjeksiyon hızıyla ilgili literatür bilgisi sınırlıdır. Yenidoğan döneminde K vitamininin yan etkilerini azaltmak için enjeksiyonun yavaş olması gerektiği ilaç üreticisi tarafından önerilmektedir.…”

Section: Enjeksi̇yonun Hiziunclassified

“…25,27 Yenidoğan döneminde, ağrılı işlemlerde pozisyon verme ve emzirme gibi fiziksel rahatlama yöntemleri uygulama kolaylığı ve etkinliği nedeni ile idealdir. 2,7,26 Harrington ve ark.nın, 230 bebeği içeren çalışmasında; gevşek kundaklama, yan/yüz-üstü pozisyonu, pışpışlama, hafifçe sallama ve emzirme gibi fiziksel uygulamaların 2-4 aylık bebeklerde aşı sonrası ağrı skorlarının ve ağlama-nın azalmasına yol açtığı belirlenmiştir. 28 Yapılan randomize kontrollü çalışmalarda da emzirme ve sükroz solüsyonu (birkaç damla ya da yarım çay ka-şığı) verilmesinin yenidoğanlarda enjeksiyon ağrı-sını azalttığı ve bebeğin sakinleşmesini sağladığı belirtilmektedir.…”

Section: Farmakoloji̇k Olmayan Uygulamalar Yenidoğan Bebek Ve Küçük çunclassified

What are the Trues in Applicating of Intramuscular Injection to Children?: Review

Yıldız¹,

Kızıler²,

Fidancı³

et al. 2017

Turkiye Klinikleri J Nurs Sci

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Ö ÖZ ZE ET T Hemşirelik uygulamalarında intramusküler enjeksiyon, kolay bir beceri olarak düşünülmesine karşın güvenli ve uygun şekilde yapılmadığında çok ciddi komplikasyonlara yol açabilmektedir. Rahatlatma teknikleri, pozisyonu, ilaç miktarı, bölgenin seçimi ve çocukların kas kütlesi miktarı her intramusküler enjeksiyondan önce değerlendirilmeli, çocuğun yaşı ve gelişimine göre belirlenmelidir. Enjeksiyon bölgesi olarak yenidoğan ve küçük çocuklarda (<3 yaş) vastus lateralis, üç yaş ve daha büyük çocuklarda deltoid ve ventrogluteal bölge tercih edilmelidir. İntramusküler uygulamalarda uygun enjeksiyon bölgesinin seçimi kadar doğru tekniği kullanmak da önemlidir. Aynı zamanda, intramuskü-ler enjeksiyon için enjeksiyon derinliği, iğne uzunluğu ve uygulama hızının doğru belirlenmesi gerekir. Ağrı yönetimi, çocuğun yaş ya da gelişimsel özelliklerine göre ağrıyı azaltmak veya gidermek için bilinmelidir. Ağrı yönetimi için büyük yaş grubunda çocuğun işleme katılımı ve kararının alınması etkili iken küçük çocuklarda kombine farmakolojik olmayan yöntemler kullanılmalıdır. Bu nedenle, çocuk hemşirelerinin kanıta dayalı güvenli enjeksiyon uygulamalarını bilmesi önemlidir. Çocuk hemşirelerinin, intramusküler enjeksiyonlarla ilgili hasta sonuçlarını geliştirmek için en iyi uygulamaları içeren güncel literatürü takip etmesi gerekmektedir. Bu çalışmada, çocuklara uygulanan intramuskü-ler enjeksiyonun güncel literatür ve mevcut kanıtlar doğrultusunda değerlendirilmesi amaçlanmıştır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Çocuk; enjeksiyonlar, intramusküler; kanıta dayalı hemşirelik A AB BS S T TR RA AC CT T Although intramuscular injections has been thought as an easy skill in nursing practice, it may cause serious complications when it's applied in unsafe and unusual procedure. Comfort techniques, positioning, amount of drug, site selection and the amount of muscle mass of the children should be assessed prior to each intramuscular injections and determined by the child's age and development. As an injection site, vastus lateralis for newborns and small children (<3 years), the deltoid and ventrogluteal region should be preferred for children age three and older children. For intramuscular injections, it is important to use correct technique as well as to choose the correct injection site. Therewithal, injection depth, the length of the needle and the application rate should be determined correctly for intramuscular injections. Pain management should be known to eliminate or reduce pain according to the child's age term and developmental characteristics. For effective pain management, in older age groups taking child's participation and decisionmaking process are effective while combined non pharmalogical methods should be used in small children. Therefore, it is important for pediatric nurses to know safe injection practices of evidencebased practice. Nursing practice requires pediatric nurses to review current literature that includes the best practice to improve patient outcomes. The aim of this article...

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Vaccine-related pain: randomised controlled trial of two injection techniques

Cited by 72 publications

References 14 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline

What are the Trues in Applicating of Intramuscular Injection to Children?: Review

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