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Effect of vapocoolant spray and EMLA cream upon DPT vaccination pain in infants

DPT 예방접종 시 냉각 스프레이와 EMLA의 통증경감 효과

  • Jang, Gunja (Department of Nursing, Daegu University) ;
  • Jeon, Eunyoung (Department of Nursing, Daegu University) ;
  • Lee, Eunsil (Department of Pediatrics, College of Medicine, Yeungnam University)
  • 장군자 (대구대학교 간호학과) ;
  • 전은영 (대구대학교 간호학과) ;
  • 이은실 (영남대학교 의과대학 소아청소년과학교실)
  • Received : 2014.04.24
  • Accepted : 2014.05.26
  • Published : 2014.07.31

Abstract

This study aimed at identifying the effect of vapocoolant spray and EMLA (eutectic mixture of local anesthetics) cream upon DPT (diphtheria-pertussis-tetanus)vaccineassociated injection pain in infants. A nonequivalent control group pretest-posttest design was used. The subjects were 49 infants, 19 of them for control group, 15 of them for vapocoolant group, and 15 infants for EMLA group. Pulse and oxygen saturation as pain indicators were measured before and after DPT vaccination. FLACC was also measured after vaccination. The data were collected between October 2009 and June 2010 and analyzed using SPSS WIN 20.0. EMLA group had significant a little changes in pulse (F=43.37, p <.001) and oxygen saturation (F=9.86, p=.003) compared to the control and vapocoolant group. But there was no difference in FLACC pain score among three groups. This results showed that EMLA cream is an effective agent for reducing DPT vaccination-associated pain. Therefore, EMLA cream can be used to reduce pain at public health centers and clinical settings.

우리나라 질병관리본부는 전염병 예방을 목적으로 국가 필수 예방접종을 정하여 특정 시기에 접종하도록 권장하는데, 대부분의 예방접종이 만 2세 전에 집중되어 있어 필수 예방접종만 투여 받더라도 영아는 14~20회 정도 접종을 받게 된다. DPT (diphtheria, pertussis, and tetanus) 는 제2군 법정전염병인 디프테리아, 백일해, 파상풍 예방을 목적으로 생후 2, 4, 6, 18개월 영아에게 근육주사하게 된다. 근육주사 시 주사 바늘 천자 및 약물 주입에 따른 통증이 유발되는데, 본 연구는DPT 예방접종을 받는 2, 4, 6개월 영아 49명을 대상으로 예방접종 시 유발되는 통증경감을 위해 국소마취용 크림인 EMLA (eutectic mixture of local anaesthetics)와 냉각 스프레이의 통증경감 효과를 조사하였다. 연구 결과 EMLA 적용군이 대조군과 냉각 스프레이 적용군에 비하여 주사 전후 맥박수와 산소포화도에 변화가 거의 없어 생리적 반응에서 통증경감 효과가 있는 것으로 나타났다. 결론적으로 EMLA 적용 군이 통증반응에 대한 생리적 변수, 즉 맥박수와 산소포화도를 정상범주로 유지하는데 있어서 냉각스프레이보다 더 효과적인 중재로 검증되었으므로 향후 DPT 예방접종 시 EMLA 크림의 적용 가능성을 시사하는 바이다.

Keywords

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