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Tactile stimulation may not relieve injection pain in infants

DENVER — Tactile stimulation did not relieve pain in infants who were receiving immunization injections, according to data presented at the Pediatric Academic Societies’ Annual Meeting 2011, held here.

“Immunization pain in infants is not well managed, despite the use of several pain-relieving options,” said study researcher Mary-Ellen Hogan, PharmD, of the University of Toronto. “Tactile stimulation involves competition between pain and touch nerve signal transmission to the brain, and has been previously shown to reduce the pain of injections in both adults and children.”

Hogan and colleagues analyzed the effectiveness of tactile stimulation added to other methods of pain relief in 120 healthy infants aged 4 to 6 months who were undergoing routine immunization at a primary care practice. The infants were randomly assigned to tactile stimulation with usual care or usual care alone. The usual care included sucrose solution, parents holding the infant, non-procedural talk and fast injection without aspiration. Tactile stimulation involved the parent rubbing the infant’s leg near the injection site.

Pain was measured using the Modified Behavior Pain Scale (MBPS), measured by blind observers and a visual analogue scale (VAS) measured by the parents. The mean MBPS scores did not differ between the two groups. The scores were 8.2 for the infants who received usual care, vs. 8.0 for those who received tactile stimulation (P=0.57). There was also no difference between the VAS measurements, which were 60 mm for infants who received the usual care and 53 mm for infants who received tactile stimulation.

“Possible reasons why the tactile stimulation did not improve the pain could be that the parents were stressed by the infant pain and were also preoccupied with the intervention,” Hogan said. “They therefore failed to respond to the infant’s cues, and were unable to provide other soothing activities.”

Hogan noted that the limitations to the study included limited parental training of tactile stimulation and the location of the injection site on the leg.

Disclosures: Dr. Hogan reports no disclosures.

For more information:

• Hogan, M. # 2155.7. A randomized trial of tactile stimulation in infants to reduce pain from immunization. Presented at: Pediatric Academic Societies' Annual Meeting 2011; April 30-May 3, 2011; Denver.

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