Sridharan Kannan, Sivaramakrishnan Gowri
1 Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
2 School of Oral Health, Nursing and Health Sciences, College of Medicine, Fiji National University, Suva, Fiji.
J Child Health Care. 2018 Sep;22(3):393-405. doi: 10.1177/1367493518760735. Epub 2018 Feb 27.
Various interventions were observed to reduce pain following vaccination in children. This study is a network meta-analysis comparing pharmacological interventions. Electronic databases were searched for appropriate randomized controlled clinical trials comparing active pharmacological agents to reduce pain following vaccination or intramuscular injection in neonates, infants, or children. Pain score was the primary outcome measure. Random effects model was used for generating pooled estimates. A total of 23 studies were included in the network meta-analysis. Topical eutectic mixture of local anesthetics (EMLA) significantly reduced pain scores. Crying time was also observed to be lower with vapocoolant spray and 25% sucrose and glucose solutions. Quality of the evidence was observed to be either low or very low. Topical EMLA significantly reduce pain following intramuscular injections particularly vaccination. However, due to low grade quality of the evidence, more studies are obligatory.
观察到多种干预措施可减轻儿童接种疫苗后的疼痛。本研究是一项比较药物干预措施的网状荟萃分析。通过电子数据库检索了适当的随机对照临床试验，这些试验比较了活性药物制剂，以减轻新生儿、婴儿或儿童接种疫苗或肌肉注射后的疼痛。疼痛评分是主要结局指标。采用随机效应模型生成合并估计值。共有23项研究纳入了网状荟萃分析。局部麻醉剂的外用共熔混合物（EMLA）显著降低了疼痛评分。使用汽化冷却喷雾以及25%蔗糖和葡萄糖溶液时，哭闹时间也较短。证据质量被观察为低或极低。外用EMLA可显著减轻肌肉注射尤其是接种疫苗后的疼痛。然而，由于证据质量等级较低，必须开展更多研究。
