Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn.

OBJECTIVE: To estimate the influence of skin-to-skin care on the thermal regulation of the infant and the rate of breastfeeding at different points of time. We also aim to establish whether skin-to-skin contact reduces maternal pain during episiotomy repair and decreases the time to expel the placenta. METHODS: A randomized control study was performed with 137 patients in each branch of the study. Differences between the study groups were analysed with the unpaired t-test, Fisher test or chi-square test as appropriate. RESULTS: Greater thermal stability in the skin-to-skin care group was found where an average temperature rise of 0.07°C was observed. Mothers in the skin-to-skin care group exclusively breastfed more frequently at discharge. Mean time to expel the placenta was lesser in the skin-to-skin care group. CONCLUSION: This study shows that skin-to-skin care implies better thermal regulation and a better proportion of exclusive breastfeeding at hospital discharge.

[Evaluation of pain in a neonatal intensive care unit during endocrine-metabolic tests]. / Valoración del dolor en la unidad de cuidados intensivos neonatales durante la extracción de las pruebas endocrinometabólicas.

OBJECTIVES: To determine whether the pain suffered during the endocrine metabolic test can be lowered by adding skin to skin care to the use of sucrose. To establish factors that may modify the feeling of pain and evaluate the parents opinion during the extraction. PATIENTS AND METHODS: Controlled clinical trial. Two groups: group 1 (n= 27), skin to skin and sucrose, and group 2 (n=27), sucrose. The pain was measured with the Neonatal Infant Pain Scale (NIPS) during the endocrine metabolic test. Patients on mechanical ventilation, with HIV III or IV and those who had been given sedative analgesics in the previous 24 hours were excluded. RESULTS: The average gestational age in group 1 was 35.1 +/- 3.5 weeks and 35.4 +/- 3.2 weeks for group 2. The NIPS in group 1 was 2.51 +/- 1.42 and 2.81 +/- 2.11 (NS) in group 2. On only one occasion was severe pain noticed (group 2). There was a tendency towards a higher NIPS with a higher gestational age (r=0.19) and a lower number of previous capillary (r= -0.06) and venous (r= -0.11) extractions. Group 1 parents thought that this practice contributed to decreasing their children's irritability and increased their trust in the care team. CONCLUSION: By adding skin to skin care to the sucrose during the endocrine metabolic test does not relieve the pain feeling. Parents in the skin to skin group thought that this practice contributed to decreasing their children's irritability and increased their trust in the care team.

Valoración del dolor en la unidad de cuidados intensivos neonatales durante la extracción de las pruebas endocrinometabólicas / Evaluation of pain in a neonatal intensive care unit during endocrine-metabolic tests

Objetivos: Determinar si el dolor ocasionado durante la realización de las pruebas endocrinometabólicas puede disminuirse realizando cuidado piel con piel, además de con el uso de sacarosa. Establecer factores que puedan modificar la sensación dolorosa y valorar la opinión de los padres durante la extracción. Pacientes y métodos: Se trata de un ensayo clínico controlado, con dos grupos: grupo 1 (n=27): con cuidado piel con piel y sacarosa, y grupo 2 (n=27): con sacarosa. Se valoró el dolor mediante la escala Neonatal Infant Pain Scale (NIPS) durante la extracción. Se excluyeron los pacientes con ventilación mecánica, con hemorragia intraventricular (HIV) de grados III o IV, o que hubieran recibido analgésicos-sedantes en las 24 h previas. Resultados: La edad gestacional media en el grupo 1 fue 35,1 ± 3,5 semanas y en el grupo 2 de 35,4 ± 3,2 semanas. El NIPS en el grupo 1 fue 2,51 ± 1,42 y en el grupo 2, 2,81 ± 2,11 (NS). En una ocasión se apreció dolor intenso (grupo 2). Se observó una tendencia a obtener un mayor valor del NIPS a mayor edad gestacional (r=0,19) y a menor número de extracciones capilares (r= -0,06) y venosas previas (r =-0,11). Los padres de los niños del grupo 1 refirieron que creían contribuir a una menor irritabilidad de sus hijos y que aumentaba su confianza con el personal asistencial. Conclusión: Añadir el contacto piel con piel a la administración de sacarosa durante la extracción de las pruebas endocrinometabólicas no disminuye la sensación dolorosa medida mediante la puntuación NIPS. Los padres que realizaron el contacto piel con piel valoraron de forma muy positiva su implicación en el procedimiento, creyendo contribuir a una menor irritabilidad de sus hijos, además de tener una sensación de mayor confianza respecto al personal asistencial (AU)

Objectives: To determine whether the pain suffered during the endocrine metabolic test can be lowered by adding skin to skin care to the use of sucrose. To establish factors that may modify the feeling of pain and evaluate the parents opinion during the extraction. Patients and methods: Controlled clinical trial. Two groups: group 1 (n= 27), skin to skin and sucrose, and group 2 (n=27), sucrose. The pain was measured with the Neonatal Infant Pain Scale (NIPS) during the endocrine metabolic test. Patients on mechanical ventilation, with HIV III or IV and those who had been given sedative analgesics in the previous 24 hours were excluded. Results: The average gestational age in group 1 was 35.1 ± 3.5 weeks and 35.4 ± 3.2 weeks for group 2. The NIPS in group 1 was 2.51 ± 1.42 and 2.81 ± 2.11 (NS) in group 2. On only one occasion was severe pain noticed (group 2). There was a tendency towards a higher NIPS with a higher gestational age (r=0.19) and a lower number of previous capillary (r= -0.06) and venous (r= -0.11) extractions. Group 1 parents thought that this practice contributed to decreasing their children's irritability and increased their trust in the care team. Conclusion: By adding skin to skin care to the sucrose during the endocrine metabolic test does not relieve the pain feeling. Parents in the skin to skin group thought that this practice contributed to decreasing their children's irritability and increased their trust in the care team (AU)

Síndrome opercular secundario a encefalitis aguda en la infancia / Opercular syndrome secondary to acute encephalitis in childhood

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