Abstract

Background and Aims: Neonates routinely undergo painful cutaneous procedures as part of their medical treatment, and during vaccination. Effective pain management is a desirable standard of care for newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools.BCG vaccines are given to all newborns under universal immunization program and a major cause of pain in neonates. Lidocaine-prilocaine 5% cream (EMLA) is a topical anaesthetic that may be useful for diminishing the pain from these procedures. So the present study was planned to know the effectiveness of EMLA in alleviating pain during BCG vaccination given at Birth.

Methods: A total of 280 neonates meeting inclusion criteria and received BCG vaccine at the time of birth were enrolled in the study. They were divided in two groups each with 140 participants. Group 1 had received BCG vaccine after application of EMLA 1hour prior to vaccine (case group) and group 2 received vaccine after application of placebo (control group). Pain was assessed on NIPS scale in both the groups immediately after immunization, at 30 second and at 60 seconds after immunization.

Results: NIPS scores at all the intervals were significantly lower when the vaccine was given after EMLA  (Group 1) compare to group 2 who was immunized after placebo( P value of<0.0001)

Conclusion: Pain perceived by the newborn after EMLA application during BCG vaccine was less as compared to the placebo group.

Keywords: Neonatal Infant Pain Scale Score (NIPS), BCG Vaccine, Intramuscular, EMLA (eutectic mixture of lidocaine and prilocaine).