Andre, age 6, is about to have an injected immunization. He is tearful and apprehensive about pain. Which of the following would be the most effective method to reduce the pain of an injection?

Andre, age 6, is about to have an injected immunization. He is tearful and apprehensive about pain. Which of the following would be the most effective method to reduce the pain of an injection?

• A. Providing postinjection analgesics, such as acetaminophen
• B. Using a topical anaesthetic cream
• C. Distracting the child during the injection
• D. Having the parent hold the child during the injection

Answer: (B)

Numbing the skin before the needle goes in is the most effective way to reduce injection pain. A topical anesthetic cream, applied to the injection site and left in place under an occlusive dressing, lowers the nerve signals that cause pain at the moment of puncture. This direct reduction in sensation makes the procedure much more tolerable for a young child. For best effect, apply it well in advance—about 30 to 60 minutes—so the skin is adequately numb when the injection occurs. Other strategies help with comfort or anxiety but don’t decrease the needle’s pain as effectively. Distracting the child can lessen distress and focus, but it doesn’t reduce the actual painful sensation. Having a parent hold the child provides support and reassurance, yet it doesn’t change the nerve signals from the skin. Postinjection analgesics address pain after the injection is done, not during the needle insertion.

Numbing the skin before the needle goes in is the most effective way to reduce injection pain. A topical anesthetic cream, applied to the injection site and left in place under an occlusive dressing, lowers the nerve signals that cause pain at the moment of puncture. This direct reduction in sensation makes the procedure much more tolerable for a young child. For best effect, apply it well in advance—about 30 to 60 minutes—so the skin is adequately numb when the injection occurs.

Other strategies help with comfort or anxiety but don’t decrease the needle’s pain as effectively. Distracting the child can lessen distress and focus, but it doesn’t reduce the actual painful sensation. Having a parent hold the child provides support and reassurance, yet it doesn’t change the nerve signals from the skin. Postinjection analgesics address pain after the injection is done, not during the needle insertion.