A randomized controlled trial of analgesia during vaccination in adults

Although immunization injections are the most common painful medical procedures, pain-relieving interventions are not routinely used. In this randomized controlled trial, we compared the effectiveness of topical anesthesia using liposomal lidocaine to: (1) vapocoolant spray using a proprietary blend of 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane: (2) nurse-administered tactile stimulation; or (3) self-directed distraction by means of reading a magazine. Liposomal lidocaine was more effective (p <= 0.05) than distraction, as assessed by self-reported pain using the visual analog scale and global report, but did not differ from either vapocoolant spray or tactile stimulation. This information can be incorporated in immunization programs. (C) 2010 Elsevier Ltd. All rights reserved.