Efficacy of facilitated tucking combined with non-nutritive sucking on very preterm infants' pain during the heel-stick procedure: A randomized controlled trial.
Int J Nurs Stud
; 86: 29-35, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-29960105
ABSTRACT
BACKGROUND:
Reducing acute pain in premature infants during neonatal care improves their neurophysiological development. The use of pharmacological and non-pharmacological analgesia, such as sucrose, is limited per day, particularly for very preterm infants. Thus, the usual practice of non-nutritive sucking is often used alone. Facilitated tucking could be an additional strategy to non-nutritive sucking for reducing pain. To the best of our knowledge, no randomized trial has compared the combination of facilitated tucking and non-nutritive sucking to non-nutritive sucking alone.OBJECTIVES:
To compare the efficacy of facilitated tucking in combination with non-nutritive sucking (intervention group) to non-nutritive sucking alone (control group) in reducing pain during the heel-stick procedure in very preterm infants.DESIGN:
Prospective, randomized controlled trial. SETTINGS Level III and II neonatal care units, including the neurosensory care management program.METHODS:
Very preterm infants (gestational age between 28 and 32 weeks) were randomly assigned by a computer programme to the intervention or control group during a heel-stick procedure within the first 48â¯h of life. In both groups, infants were placed in an asymmetric position on a cushion; noise and light were limited following routine care. A heel-stick was performed first in the care sequence. In the intervention group, facilitated tucking was performed by a nurse or nursing assistant. The procedure was video recorded from 15â¯s (T-15â¯s) before the procedure until three minutes (Tâ¯+â¯3â¯min) after the end of the procedure. Pain was blindly assessed by two independent specialist nurses. The primary outcome was the pain score evaluated 15â¯s before the procedure and 30â¯s immediately after by the premature infant pain profile (PIPP) scale. The secondary outcome was the pain score evaluated between T-15â¯s and Tâ¯+â¯3â¯min by the DAN scale (a French acronym for the acute pain of a newborn).RESULTS:
Sixty infants were included (30 in each group). The PIPP pain scores did not differ between the intervention group (median 8.0; interquartile range (IQR) 6.0-12.0) and the control group (median 9.5; IQR 7.0-13.0, pâ¯=â¯0.32). Pain assessed by the DAN scale at Tâ¯+â¯3â¯min was lower in the intervention group than in the control group (median 0.3; IQR 0.0-1.0 and 2.0; IQR 0.5-3.0, respectively, pâ¯=â¯0.001).CONCLUSIONS:
The combined use of facilitated tucking and non-nutritive sucking did not significantly alleviate pain during the heel-stick procedure. However, the addition of facilitated tucking facilitated faster pain recovery following the heel-stick procedure.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Conducta en la Lactancia
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Recien Nacido Prematuro
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Flebotomía
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Manejo del Dolor
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Contención del Recién Nacido
Tipo de estudio:
Clinical_trials
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Observational_studies
Límite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Revista:
Int J Nurs Stud
Año:
2018
Tipo del documento:
Article