No pain vein gain with prilox in Paediatric population

Neha.N1, Suresh Chelliah2

1DNB resident, Family medicine, Kauvery Hospital, Cantonment, Trichy

2Senior Consultant Paediatrician, Kauvery Hospital, Trichy

Background

Pain is an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage.

Methods and Materials

  • Pilot study, prospective
  • Sample size – 30
  • 15 children procedures done without prilox
  • 15 children after prilox application
  • Pain assessment done
  • Results compared
  • Inference obtained.

Definition

Prilox, a combination of prilocaine (2.5%) and lidocaine (2.5%), is a local anesthetic widely used in various medical procedures to alleviate pain. It inhibit nerve signals in the targeted area.

It work by numbing the skin to reduce pain or discomfort during medical procedures.

Prilox-1

Age

Experimental group

Control group
Number Percentage Number Percentage
4-7 3 20 4 26
8-12 8 53 5 33
13-18 4 26 6 40

Methods of Pain Assessment with Prilox

Visual Analog Scale (VAS)

Patients indicate their pain intensity on a scale from 010,

  1. The 0 – representing no pain and 10 the worst imaginable pain.
  2. This subjective measure allows healthcare providers to gauge the effectiveness of Prilox in real-time.
Prilox-2

Numerical Rating Scale (NRS)

Similar to VAS, the NRS asks patients to rate their pain on a numerical

Scale. It provides a quick and reliable method for assessing pain levels before and after the administration of Prilox.

Prilox-3

Wong-Baker Faces Pain Scale

The rating in Wong-Baker pain scale is similar to the numerical rating but it combines pictures with the number for the rating of the pain. A tool that uses a combination of faces, numbers, and words to help a person effectively communicate the severity of their physical pain. This scale can be used even for children as they can point to the face that depicts their intensity of pain.

Prilox-4

FLACC pain scale (The Face, Legs, Activity, Cry, Consolability)

  1. It was used to assess pain for children between the ages of 2 months and 7 years or individuals that are unable to communicate their pain.
  2. The scale is scored in a range of 010 with 0 representing no pain.
  3. The scale has five criteria, which are each assigned a score of 0, 1 or 2.
Prilox-5

 

Observational and Behavioural Assessments

Especially relevant for pediatric or non-verbal patients, healthcare providers can observe behavioural cues such as,

  1. Facial expressions,
  2. Body language,
  3. Changes in vital signs to assess pain levels.

Patient Interviews

Open communication with patients about their pain experience helps in tailoring Prilox administration to individual needs.

Gathering information about the onset, duration, and quality of pain contributes to a more comprehensive assessment

Level of Pain

Experimental group

Control group
Number Percentage Number Percentage
Mild

(0-2)

 15 100 1 6
Moderate

(4-6)

 0 0 2 13
Severe

(8-10)

 0 0 12 80

Intensity of pain has a relationship with duration of prilox application.

  1. Better pain score with prolonged duration of prilox application.
  2. Prilox works best if it is applied to the dermal site at least 1 hr before the procedure and covered with an occlusive dressing.

Results and Discussion

Efficacy of Prilox

  1. The study demonstrated a significant reduction in pain scores following Prilox administration across various procedures.
  2. The majority of paediatric patients reported minimal to no pain during and after interventions.

Safety Profile

  1. Prilox exhibited a favourable safety profile, with a low incidence of adverse events.
  2. No severe complications or systemic reactions were observed during the study period.

Age and Procedure-Related Differences

  1. Subgroup analyses were conducted to explore potential variations in Prilox efficacy and safety based on age groups and the nature of the Medical procedure.

Advantage

Least Expensive

Disadvantages

  1. Its use is limited because of the time needed for onset of Anaesthesia
  2. Risk of Methaemoglobinemiapyruvate kinase deficiency

Conclusion

Prilox emerges as an effective and safe local anesthetic for paediatric pain management during venflon insertion and blood investigations. The findings of this study contribute valuable insights into optimizing pain management strategies for children, promoting a more comfortable and positive healthcare experience. Further research and long-term follow-ups are recommended to strengthen the evidence base and ensure the continued safety and efficacy of Prilox in paediatric populations.

Neha

Dr. Neha. N

DNB Resident

Suresh-Chelliah

Dr. D. Suresh Chelliah

Senior Consultant Paediatrician

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