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.