Researchers find that despite evidence of efficacy, topical anesthetics analgesics are not commonly used for routine immunization



    TORONTO, Sept. 4 /CNW/ - Researchers at The Hospital for Sick Children
(SickKids) have found that even though topical anesthetics have been shown to
reduce pain during routine immunizations, they are not widely used in the
community. This research is reported in the September 4 issue of the journal
Pediatrics.
    Childhood immunizations are traumatic for children, their families,
health care workers, and society at large. Beyond the acute injection and
post-injection pain, repeated immunizations lead to pre-procedural anxiety and
hypersensitivity to future painful procedures. In its most extreme form it can
lead to avoidance of medical care because of "blood-injection-injury phobia."
The stress upon parents is also profound, leading some parents to become
noncompliant with vaccine administration, which in turn contributes to the
risk of resurgence of vaccine-preventable disease.
    The trauma of having a painful needle experience can last a lifetime.
Studies have shown that most needle phobias develop between the age of 4 and 6
and about 10 per cent of the population is needle phobic. More than 50 per
cent of school aged children are afraid of needles.
    Topical anesthetics such EMLA cream (lidocaine-prilocaine) and Ametop gel
(amethocaine) have been proven to be highly effective at reducing injection
pain, however SickKids researchers found in a survey of physicians and parents
that they were rarely used as part of their vaccination pain management
strategy. Oral analgesics such as Tylenol (acetaminophen) and Advil
(ibuprofen), however, were used more commonly to manage pain.
    The researchers found these results surprising, because scientific
evidence consistently supports topical local anesthetics for injection pain
but such evidence is equivocal for the use of oral analgesics, which were used
more frequently to manage injection and post-injection pain.
    "Topical anesthetics do not prevent all pain, but they do reduce it, by
about half," said Dr. Anna Taddio, the study's lead author and principal
investigator, an adjunct scientist in Child Health Evaluative Sciences at the
SickKids Research Institute and pharmacist, and an associate professor of
Pharmacy at the Leslie Dan Faculty of Pharmacy at the University of Toronto.
"There is an expectation that topical anesthetics make injections pain free.
Since they do not, people have not adopted their use."
    Taddio noted that topical anesthetics take about 30-60 minutes to become
effective which some paediatricians cited as a barrier to use. Parents, on the
other hand, reported that they were unfamiliar with topical local anesthetics,
but had been informed about oral analgesics.
    "The good news is that if doctors endorse the use of topical anesthetics,
like they endorse the use of oral analgesics, patients would use them. We have
to make sure parents know about them," added Taddio.
    Other researchers involved in this study were Jennifer Manley, Leah
Potash and Moshe Ipp from SickKids, Michael Sgro of St. Michael's Hospital and
Vibhuti Shah of Mt. Sinai Hospital.
    This research was funded by the Canadian Pain Society, the Canadian
Institutes of Health Research and SickKids Foundation.

    The Hospital for Sick Children (SickKids), affiliated with the University
of Toronto, is Canada's most research-intensive hospital and the largest
centre dedicated to improving children's health in the country. As innovators
in child health, SickKids improves the health of children by integrating care,
research and teaching. Our mission is to provide the best in complex and
specialized care by creating scientific and clinical advancements, sharing our
knowledge and expertise and championing the development of an accessible,
comprehensive and sustainable child health system. For more information,
please visit www.sickkids.ca. SickKids is committed to healthier children for
a better world.




For further information:

For further information: Lisa Lipkin, Public Affairs, The Hospital for
Sick Children, (416) 813-6380, lisa.lipkin@sickkids.ca

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