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W. Retayasa
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Health Professions Medicine & Pharmacology

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Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial Nugroho Karyadiguna; Soetjiningsih Soetjiningsih; W. Retayasa; M. Kardana
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (342.962 KB) | DOI: 10.14238/pi47.1.2007.12-6

Abstract

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infant’s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infant’s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.
Effect of oral vitamin K prophylaxis on prothrombine time and activated partial thromboplastin time: a randomized controlled comparison with an intramuscular vitamin K in infants V. Lily Limantara; Sudaryat S.; I. B. Mudita; W. Retayasa; M. Kardana
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (441.269 KB) | DOI: 10.14238/pi47.3.2007.109-14

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Background Low plasma concentration of vitamin K in thenewborn accounts for serious bleeding in the neonatal period andearly infancy. The aim of prophylactic vitamin K is to preventbleeding. Oral prophylaxis is preferable to intramuscular (IM)administration because oral administration is less expensive andless traumatic.Objective To compare oral vs. intramuscular vitamin K onprothrombine time (PT) and activated partial thromboplastin time(APTT) during the first 60 days of life.Methods We randomized newborn infants to either receive oralvitamin K 2 mg at birth and repeated at 7 and 30 days of life orthe 1 mg intramuscular vitamin K. PT and APTT were monitoredat 0, 15, and 45 days of age. Independent t-test, repeatedmeasurement, and regression analysis were used for statisticalanalyses and comparison of the results.Results Fifty infants were assigned into the oral group and 50 tothe IM group. All participants completed 60 days of study. BothPT and APTT decreased after administration of oral or IM vitaminK, and the values did not differ significantly at any time pointand through the period of investigation. Using regression analysisit was shown that only vitamin K administration was correlatedwith PT and APTT with P value were 0.044 and 0.036,respectively. During 60 days of study, there was no hemorrhagicdiathesis in both groups.Conclusions Through the first 60 days of life, 3 doses of oralvitamin K maintain hemostasis by decreasing PT and APTT ininfants at values equal to those achieved by the intramuscularpreparation. Diathesis hemorrhagic event did not occur in bothgroups.
Co-Authors I. B. Mudita M. Kardana Nugroho Karyadiguna Soetjiningsih Soetjiningsih Sudaryat S. V. Lily Limantara