• K L Cassidy, G J Reid, P J McGrath, D J Smith, T L Brown, and G A Finley.
• Department of Medicine, Izaak Walton Killam Health Centre, and Dalhousie University, Halifax, Nova Scotia, Canada. kcassidy@istar.ca
• Acta Paediatr. 2001 Nov 1;90(11):1329-36.

UnlabelledThe effectiveness of a eutectic mixture lidocaine-prilocaine topical anaesthetic cream (EMLA) patch compared with a placebo patch in the reduction of pain associated with intramuscular immunization was evaluated. As part of the study, 161 children (aged 4-6-y) undergoing routine diphtheria, pertussis, tetanus and polio (DPTP) immunization in five urban and five rural private office settings were randomly assigned to an EMLA patch (n = 83) or a placebo patch control group (n = 78). Pain measurements included: child's self-report on a Faces Pain Scale; facial action on the Child Facial Coding System; the Children's Hospital of Eastern Ontario Pain Scale and parent and technician ratings on a Visual Analogue Scale. Parents also rated their own and their child's immunization-related anxiety on a Visual Analogue Scale. The EMLA patch group had significantly less pain on all four pain measures compared with the placebo group. Of the children in the placebo group, 43% had clinically significant pain, compared with 17% of children in the EMLA patch group. No severe adverse symptoms occurred as a result of either EMLA or placebo patch application.ConclusionThe EMLA patch reduced immunization pain in 4 to 6-y-old children during needle injection.

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