We recruited 60 infants in each group to account for missing data and dropouts. We compared pain after the first vs second injection for all infants using the paired-samples t test.
All analyses were conducted using a commercially available software program SPSS, version The study was conducted between July 21, , and June 21, Of parents of infants approached for participation, infants were eligible and all of the parents agreed to let their children participate. Demographic characteristics did not differ between groups Table 2.
DPTaP-Hib indicates diphtheria and tetanus toxoids, polio, and acellular pertussis and Haemophilus influenzae type b; PCV, pneumococcal conjugate vaccine. In all infants, pain increased from the first to the second injection observer MBPS score, 7. Infant pain response during routine intramuscular vaccine injection was affected by the order of administration of the vaccine. Infants given the less painful DPTaP-Hib vaccine first followed by the more painful PCV experienced less pain overall when compared with those given the vaccines in the reverse order.
In addition, pain increased from the first to the second injection, regardless of the order of vaccine injection. Our finding of variability in pain from different vaccine formulations is consistent with previous research.
The 2 vaccines used in this study have several differences Table 1 , including pH, which may account for the pain variability. In addition, our finding of an increase in pain with subsequent injections in infants exposed to repeated painful procedures is consistent with research in infants undergoing repeated heel lances 4 and vaccine injections. To our knowledge, the effect of varying the order in which vaccines of different degrees of painfulness are given has not previously been examined.
Our data suggest that the least painful vaccine should be administered first when 2 vaccines are given at 1 physician's visit to reduce overall pain. We hypothesize that, in the alternative, giving the more painful injection first focuses the infant's attention on the procedure and activates central and peripheral mechanisms of pain processing that together result in amplification of the pain signal during subsequent injections administered immediately thereafter.
Minimizing the pain of vaccine injection experienced by infants and children is currently receiving considerable attention by clinicians and pain researchers.
Reductions in pain therefore have the potential to improve compliance with the vaccination schedule, thereby preventing a resurgence of vaccine-preventable infections. Varying the order of vaccine administration to reduce pain is a strategy that is simple and effective, cost free, and easily incorporated into clinical practice.
In considering methods of reducing pain with vaccination, vaccine manufacturers must play a more integral role in attempting to produce vaccine formulations that are less painful. Acquisition of data : Ipp, Lear, and Goldbach.
Analysis and interpretation of data : Ipp, Parkin, and Taddio. A larger needle is used for intramuscular injections, and when it reaches the muscle layer, the needle can break muscle fibers, which can trigger a pain response. On top of this, broken muscle fibers can trigger your immune response to cause inflammation and result in injection site pain.
This can cause additional pain and adverse reactions such as redness and swelling. These are normal responses to injections, and the injection area can feel sensitive days after injection.
However, if you have a history of painful injections, you might be discouraged from undergoing cosmetic procedures like dermal fillers because of the potential pain you might experience. Fortunately, microcannulas offer a more comfortable experience compared to your typical sharp needles. Instead of sharp, non-bendable needles, syringes can be connected to microcannulas, a thin and flexible tube with a round blunt tip. Microcannulas come in various lengths, allowing doctors more reach as necessary.
At the start of a dermal filler procedure, a medical professional sterilizes your treatment area with an alcohol pad and then creates a minute hole in your skin using a sharp needle. The needle used is sharp enough to puncture the skin with minimal pain, but it only goes deep enough to provide the microcannula enough access to your skin.
Your doctor may even use a topical anesthetic to help reduce the pain. Afterwards, the microcannula is inserted into the entry point and moved to the area that requires filler injections. Because of its flexibility, the microcannula does not break connective tissues.
Instead, it slides within the spaces connecting the dense tissue, causing little to no pain compared to a needle. Microcannulas can offer these advantages compared to the usual dermal fillers that use hypodermic needles. Patients who have used microcannulas report a much more comfortable experience.
Rather than multiple injections with a needle which can cause the needle to go dull , only one point of entry is needed for nearby points that require fillers. Sharp injections can cause skin tearing, bruising, and swelling. It can also disturb a blood vessel, which can cause pain during and after the procedure while the skin tissue repairs itself.
Unlike sharp needles where movement is limited to angular direction, microcannulas are flexible and allow doctors more movement to fill in the right places in your cheeks, lips, nose, and other parts of your face that need fillers.
More accurate fillers can result in a more successful procedure that can have smoother, more natural-looking results. Animals This frog mysteriously re-evolved a full set of teeth. Animals Wild Cities Wild parakeets have taken a liking to London.
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Many people who are now adults were pinned down as kids when it was time for shots. With the right pain control and distraction, kids should rarely need to be held down. From blowing bubbles to letting your child play a game on your phone, there are all sorts of distractions that can make getting a shot less anxiety-producing.
Clark agreed that distraction can be helpful, as is engaging the child throughout the process. Good distractions can be singing a song, allowing the child to talk, or encouraging them to cough at the exact time of the shot. Instead, use a distracting statement or talk to your child about coping mechanisms when they get shots. Role-playing before the office visit can be especially useful with kids ages 2 to 5, Clark said. You can also use a book or video as a tool to introduce the child to what will happen.
Chambers said parents should ask their doctors what can be done to manage needle-related pain. Often, that can start a useful dialog or allow physicians to share their tips on what works.
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