{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T17:28:35Z","timestamp":1784050115106,"version":"3.55.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,12,1]]},"abstract":"<jats:p>Objectives. Ametop gel (4% amethocaine) is a relatively new topical anesthetic that produces anesthesia within 30 to 45 minutes and therefore may be appropriate for use in busy outpatient settings. The objective of this study was to assess the efficacy and safety of 4% amethocaine in reducing the pain of subcutaneous measles-mumps-rubella vaccination in 1-year-old infants.<\/jats:p><jats:p>Methods.A double-blind, randomized, placebo-controlled trial was conducted in pediatric outpatient clinics.<\/jats:p><jats:p>Results.A total of 120 infants participated in the study; 60 were followed up for assessment of antibody titers after 1 month. Either 1 g of amethocaine or placebo was applied for 30 minutes before vaccination. The Modified Behavioral Pain Scale was used to assess pain; the mean (standard deviation) pain scores for the amethocaine group (n = 61) was 1.5 (1.6) versus 2.3 (2.2) for the placebo group (n = 59). The rate of vaccination success (88% and 87%) was not different between treatment groups.<\/jats:p><jats:p>Conclusions.4% Amethocaine significantly reduces the pain of measles-mumps-rubella vaccination in infants when compared with placebo and does not seem to interfere with subsequent development of protective antibody levels. Because of its relatively short application time (30 minutes), 4% amethocaine may be suitable for busy clinics and emergency departments.<\/jats:p>","DOI":"10.1542\/peds.2004-0722","type":"journal-article","created":{"date-parts":[[2004,12,11]],"date-time":"2004-12-11T22:27:41Z","timestamp":1102804061000},"page":"e720-e724","source":"Crossref","is-referenced-by-count":30,"title":["Topical 4% Amethocaine Gel Reduces the Pain of Subcutaneous Measles-Mumps-Rubella Vaccination"],"prefix":"10.1542","volume":"114","author":[{"given":"Lisa","family":"O'Brien","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology and Toxicology, Toronto, Ontario, Canada"},{"name":"Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Taddio","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Pharmacy, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Ipp","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morton","family":"Goldbach","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Koren","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology and Toxicology, Toronto, Ontario, Canada"},{"name":"Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2004,12,1]]},"reference":[{"key":"2021120819402671500_R1","doi-asserted-by":"crossref","unstructured":"Taddio A, Nulman I, Koren BS, et al. A revised measure of acute pain in infants. J Pain Symptom Manage.\u20081995;10:456\u2013463","DOI":"10.1016\/0885-3924(95)00058-7"},{"key":"2021120819402671500_R2","unstructured":"Health Canada\u2013Population and Health Protection Branch. Canadian Immunization Guide. 6th ed. Health Canada, Ottawa, Canada: Canadian Medical Association; 2002"},{"key":"2021120819402671500_R3","unstructured":"American Academy of Pediatrics. Active and passive immunization: report of the Committee on Infectious Diseases. In: Pickering LK, ed. Red Book. Elk Grove Village, IL: American Academy of Pediatrics; 2003:24"},{"key":"2021120819402671500_R4","doi-asserted-by":"crossref","unstructured":"Uhari M. A eutectic mixture of lidocaine and prilocaine for alleviating vaccination pain in infants. Pediatrics.\u20081993;92:719\u2013721","DOI":"10.1542\/peds.92.5.719"},{"key":"2021120819402671500_R5","doi-asserted-by":"crossref","unstructured":"Taddio A, Nulman I, Goldbach M, et al. Use of lidocaine-prilocaine cream for vaccination pain in infants. J Pediatr.\u20081994;124:643\u2013648","DOI":"10.1016\/S0022-3476(05)83150-6"},{"key":"2021120819402671500_R6","doi-asserted-by":"crossref","unstructured":"Halperin SA, McGrath P, Smith B, et al. Lidocaine-prilocaine patch decreases the pain associated with the subcutaneous administration of measles-mumps-rubella vaccine but does not adversely affect the antibody response. J Pediatr.\u20082000;136:789\u2013794","DOI":"10.1016\/S0022-3476(00)64169-0"},{"key":"2021120819402671500_R7","doi-asserted-by":"crossref","unstructured":"Halperin BA, Halperin SA, McGrath P, et al. Use of lidocaine-prilocaine patch to decrease intramuscular injection pain does not adversely affect the antibody response to diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b conjugate and hepatitis B vaccines in infants from birth to six months of age. Pediatr Infect Dis J.\u20082002;21:399\u2013405","DOI":"10.1097\/00006454-200205000-00010"},{"key":"2021120819402671500_R8","doi-asserted-by":"crossref","unstructured":"Choy L, Collier J, Watson AR. Comparison of lignocaine-prilocaine cream and amethocaine gel for local analgesia before venepuncture in children. Acta Paediatr.\u20081999;88:961\u2013964","DOI":"10.1111\/j.1651-2227.1999.tb00190.x"},{"key":"2021120819402671500_R9","doi-asserted-by":"crossref","unstructured":"Arrowsmith J, Campbell C. A comparison of local anaesthetics for venepuncture. Arch Dis Child.\u20082000;82:309\u2013310","DOI":"10.1136\/adc.82.4.309"},{"key":"2021120819402671500_R10","doi-asserted-by":"crossref","unstructured":"Lawson RA, Smart NG, Gudgeon AC, et al. Evaluation of an amethocaine gel preparation for percutaneous analgesia before venous cannulation in children. 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