Effective Analgesia Using Physical Interventions for Infant Immunizations
Pediatrics, 05/14/2012
Harrington JW et al. – Physical intervention of the 5 S’s (swaddling, side/stomach position, shushing, swinging, and sucking) provided decreased pain scores on a validated pain scale and decreased crying time among 2– and 4–month–old infants during routine vaccinations. The use of 5S’s did not differ from 5S’s and sucrose.
Methods- The authors conducted a prospective, randomized, placebo-controlled trial with 2- and 4-month-old infants during well-child visits.
- Patients were assigned into 4 groups (2 × 2) receiving either 2 mL of water or 2 mL of 24% oral sucrose and then either standard-of-care comfort measures by parents or intervention with the 5 S’s immediately postvaccination.
- The Modified Riley Pain Score was used to score the infants’ pain at 15-second intervals for 2 minutes, then every 30 seconds up to 5 minutes postvaccination.
- Repeated-measures analysis of variance examined between group differences and within-subject variability of treatment effect on overall pain scores and length of crying.
- Results revealed significantly different mean pain scores between study groups with the exception of the 5S’s and 5S’s with sucrose groups.
- These 2 groups had lower similar mean scores over time, followed by sucrose alone, then control.
- The same trend was found with the proportion of children crying as with the mean pain score outcome measure.



