ÇOCUKLARDA İNTRAMÜSKÜLER ENJEKSİYONLARDAN ÖNCE KREM EMLA Eutectic Mixture of Lokal Anastetic UYGULAMASI İLE İŞLEM ÖNCESİ EĞİTİM VERİLEREK YAPILAN HAZIRLIĞIN AĞRIYI AZALTMADAKİ ETKİNLİĞİNİN İNCELENMESİ

Araştırma 7-12 yaş grubu çocuklar arasında intramüsküler enjeksiyon - lardan önce lokal anestetik etkili Krenı EMLA uygulaması ile hemşirclerin işlem öncesi eğitim vererek yaptığı hazırlığın ağnyı azaltmadaki etkinliklerini incele - mek amacıyla yapılmıştır. Deneysel olarak yapılan araştırmanın örneklemini 16 çocuk Krem EMLA. 16 çocuk eğitim grubu ve 16 çocuk kontrol grubu olmak üzere 48 çocuk oluşturmuştur. Çocuklar her 3 grupta da 7 -9 yaş ve 10-12 yaş olarak gruplara aynlmış ve her grup 8 kız ve 8 erkek çocuktan oluşturulmuştur. Araştırmaya dahil edilen tüm çocuklann annelerinden izin alınmıştır. Krem EMLA grubunu oluşturan çocuklara intramCısküler enjeksiyondan bir saat önce, enjeksiyon uygulanacak bölgeye Krem EMLA uygulanmış ve üzeri plastik bandaj ile kapatılmıştır. Eğitim grubundaki çocuklara işlemle ilgili broşür okutularak bilgi verilmiş, resimler gösterilmiştir ve işlem bir bebek üzerinde kendilerine yaptınimıştır. Herhangi bir hazırlık yapılmadan enjeksiyon uygulanan çocuklar ise kontrol grubunu oluşturmuştur.

Anahtar Kelimeler:

Ağrı. Krem EMLA Lokal anestetlk etkili pomat . iııtramüsküler enjeksiyon

IN EXAMINATION OF THE EFFICIENCY OF CREAM EMLA APPLICATION AND EDUCATIONAL PREPARATION OF CHILDREN IN ALLEVIATION OF THE PAIN CAUSED BY 1M INJECTION

7his study has been carried out iri order to examine the effects of the application of cream EMLA and educational preparation of children. who are in 7- 12 age group. in the alleviation of the pain caused by 1M injection. 7fie study has been planned as an experimantal researclı. and study sample corısisted of 48 children. 16 of hem received the educational preparation. 16 of hem received cream EMLA application and the rest 16 conıprised of 8 girls and 8 boys who are in the age groups of 7-9 and 10-12. Permission was obtained _fro► the mothers of children. Crcam EMLA was applicd an İmir before the 1m injection and the area was covered with plastic strip. ille children who are in the educational preparation group were informed by a brochııre. pictures and were quided to apply injection on a baby toy. 711e children who received no preparation were considered as control group. In the collection of the dala, the Visual Analog Scale VAS was impleınerıted. iri which the children scored their VAS just after their 1M injections. Evenj clıild scored the scale 3 ti►es to ablaM a mean pain score. In the analysis of the data. the tesis of Man Whitney-U. Clıi-Square and Knıskal Wallis were applied. As a restılt of the evaluation. there was no difference among the mean scores of the groups of cream EMLA. teaching. and control. Accordingly. it has been determineel that cream EMLA application is especially effective in the 7 -12 age group in the clıildren's educational preparation for injection. GİRIS

Keywords:

Pain. Cream EMLA Eutectic Mixture of Local Anaestetic. Intramusculer injectlon,

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BJerring P. Nielson LA (1990) Depth and duratlon of skin analgesia to needle insertion after topical application of EMLA creanı. Br. J. Anaesth 64. 173-177.
Brennan A (1994) Caring for children during procedures: a rcvicw of the literature. Pediatric Nurs. 9:1. 451-456.
Broome ME (1990) Preparation of children for painful procedures. Pediatric Nurs. :16. 537-540.
Clarke S. Radford M (1986) Topical anastlıesia for venipuncture. ach of Disease in Childhood 61. 1132-1134.
Ehrenstriinı Reiz GMe. Reiz SLA (1982) EMLA-a eutectic mbcture of local anacsthetics for topical anaesthesia. Ada Anaesth. Scand. 26. 596-598.
Ever H. Von Dardel O. Juhlin L ve ark (1985) Dermal effects of compositions based on the eutetic mLxture of lignocaine and prilocaine (EMLA) Er. J. Anaesth. 57. 997
Ferrel BR. Mc Caffcry M. Ropchan R (1992) Pain nıanagemcnt as a clinical challenge for nıırsing administration. NursIng Outlook. 40: 6. 263-268.
Hallen B. Uppfeldt A (1982) Docs lidocaine prilocaine cream permit pain frce insertation of IV catheter in children. Anaesthesiolow. 57. 340-342.
Hallen B. Carlsson P. Uppfeldt A (1985) Clinical study of a ligrıocaine prilocaine cream to relieve tlıe pain of venipuncturc. Er. J. Anaesth. 57. 326-328.
Halperin DL. Koren G. Attias D ve ark (1989) Topical skinanethesia for venous subcutaneous drug rescrvoir and lumbar punctures in clıildren. Pediatrics. 84:2. 284. 1. Harrison A (1991) Preparing children for venous blood sanıpling. Pain. 45. 299-306.
Jacobson B. Nilsson A (1985) Methemoglobinemia associated with a pnlocaine- liclocaine cream and trimetoprim-sulphamethorczaloe-a case report. Acta Anaestesiol Scand. 29. 453-455.
Kapelushnik I. Karen G. Solh H ve ark. Evaluating the efficiancy of EMLA in alleviating pain associated with lumbar puncture: comparison of open and double- blinded protocols in children. Pain. 42. 31-34. Kocaman G (1994) Agn. Saray Kitapevi. 147-157.
Karen G (1991) Use of the eutectic mixture of local anaesthetics in young children for procedure relatecl pain. The Joumal of Pedlatrics. 1220 5. 30-35.
Maner T. Kanla E. Lisalo R ve ark (1987) Reduction of pain at venous cannulation in children with cutcUc mbcture of lidocalne and prilocaine (EMLA cream►: comparison with placepo cream and no local premedicatIon. Acta Anaesthesiol Scand. 31. 735-739.
Sollman IE. Broadınan 1.M. Hannallah RS ve ark (1988) Comparison of the analgesic effects of EMLA (Eutectic MLxture of Local Anesthetics) to intradermal lidocaine infiltration prior to venous cannulation in unprernedicated children. Anaesthesiology. : 5. 804-806.
Sömböloğlıı K. Sibubüloğlu V (1988). Araştırma Yöntemleri. HaUpoglu Yayınevi. Yeniçai.,3
Basın Yayın San. Ankara. 54-60. Thonıpson V (1994) An IV thereapy teaching tool for children. Pcdiatric Nursing 20: 4. 355.
Vessey J. Carlson K. MC Gill J (1994) Use of distraction with children during an acute pain experience. Nursing Research. 43: 6. 369-372.
William J (1987) Managing pediatric pain. Nursing Times. 83: 36. 36 -40.
Willson H (1992). Painful facts. Nursing Times. 88: 35. 32 -33.
Whaley FL. Wong LD (1987) Nursing Care of Infants and Children. Third Ed. The C.V.
Mosby Conıp. St Louis. 1752.