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Published online December 1, 2004
PEDIATRICS Vol. 114 No. 6 December 2004, pp. e720-e724 (doi:10.1542/peds.2004-0722)
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ELECTRONIC ARTICLE

Topical 4% Amethocaine Gel Reduces the Pain of Subcutaneous Measles-Mumps-Rubella Vaccination

Lisa O'Brien, MSc*,{ddagger},§, Anna Taddio, BScPhm, PhD{ddagger},||, Moshe Ipp, MD, Morton Goldbach, MD, Gideon Koren, MD*,{ddagger},§,¶

* Division of Clinical Pharmacology and Toxicology, Toronto, Ontario, Canada
|| Department of Pharmacy, Toronto, Ontario, Canada
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
{ddagger} Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
§ Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada

Objectives. Ametop gel (4% amethocaine) is a relatively new topical anesthetic that produces anesthesia within 30 to 45 minutes and therefore may be appropriate for use in busy outpatient settings. The objective of this study was to assess the efficacy and safety of 4% amethocaine in reducing the pain of subcutaneous measles-mumps-rubella vaccination in 1-year-old infants.

Methods.A double-blind, randomized, placebo-controlled trial was conducted in pediatric outpatient clinics.

Results.A total of 120 infants participated in the study; 60 were followed up for assessment of antibody titers after 1 month. Either 1 g of amethocaine or placebo was applied for 30 minutes before vaccination. The Modified Behavioral Pain Scale was used to assess pain; the mean (standard deviation) pain scores for the amethocaine group (n = 61) was 1.5 (1.6) versus 2.3 (2.2) for the placebo group (n = 59). The rate of vaccination success (88% and 87%) was not different between treatment groups.

Conclusions.4% Amethocaine significantly reduces the pain of measles-mumps-rubella vaccination in infants when compared with placebo and does not seem to interfere with subsequent development of protective antibody levels. Because of its relatively short application time (30 minutes), 4% amethocaine may be suitable for busy clinics and emergency departments.

Key Words: local anesthetic • amethocaine • tetracaine • pain • infants • vaccination

Abbreviations: MMR, measles-mumps-rubella • MBPS, Modified Behavioural Pain Scale

Accepted Jul 23, 2004.


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eLetters:

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I've got the needle !
mike farrall
Pediatrics Online, 2 Dec 2004 [Full text]
Response to Dr Farrall
Gideon Koren, et al.
Pediatrics Online, 17 Dec 2004 [Full text]