Title: To study the effectiveness of EMLA in the alleviation of pain during Hepatitis B vaccination given at birth

Authors: Dr Hitender Gautam, Dr Deepak Sharma, Dr Rakesh Sharma, Dr Pancham Kumar, Dr Priyanka

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.05

Abstract

Background and Aims: 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. Reducing invasive procedures, and using pharmacological, behavioural or environmental measures can be used to manage neonatal pain. Hepatitis-B vaccines are given to all newborns under the universal immunization program. So the present study was planned to know the effectiveness of EMLA in alleviating pain during Hepatitis B vaccination given at Birth.

Methods: 280 neonates were enrolled for the study who are meeting study criteria out of all the newborns who received Hepatitis B vaccine given at birth during study period. They were divided into two groups each with 140 participants. Group 1 had received hepatitis B vaccine after application of EMLA 1hour prior to a vaccine (case group)and group 2 received vaccine after application of placebo (control group). The pain was assessed on NIPS scale in both the groups immediately after immunization, at 30 second and at 60 second 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 hepatitis B vaccine was less as compared to the placebo group.

Keywords: neonatal infant pain scale score (NIPS), Hepatitis B vaccine, intramuscular, EMLA (eutectic mixture of lidocaine and prilocaine).

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Corresponding Author

Dr Priyanka

Resident, Department of Community Medicine, IGMC, Shimla, Himachal Pradesh, India