DOI QR코드

DOI QR Code

Effectiveness of various nonpharmacological analgesic methods in newborns

  • Kumar, Pancham (Department of Pediatrics, Indira Gandhi Medical College) ;
  • Sharma, Rakesh (Department of Pediatrics, Indira Gandhi Medical College) ;
  • Rathour, Sukhdev (Department of Pediatrics, Indira Gandhi Medical College) ;
  • Karol, Sunidhi (Department of Community Medicine, PT. B. D. Sharma PGIMS) ;
  • Karol, Mohit (Department of Pediatrics, Indira Gandhi Medical College)
  • 투고 : 2017.08.05
  • 심사 : 2019.08.13
  • 발행 : 2020.01.15

초록

Background: Pain during the developmental period may adversely affect developing neuronal pathways and result in adverse neurodevelopmental, cognitive, and behavioral effects in later life. Immunizations, e.g., hepatitis B vaccine (HBV), administered at birth are painful experiences to which neonates are universally subjected. Purpose: Here we aimed to study and compare the effectiveness of various nonpharmacological pain management methods in newborns to enable the development of safe and effective analgesic methods for newborns. Methods: This prospective study was conducted at a tertiary care hospital in the Himalayan region. Three hundred term healthy neonates were divided into 6 groups of 50 each. Groups 1-5 were intervention groups, patients of which received a nonpharmacological intervention (breastfeeding, nonnutritive sucking, rocking, 25% sucrose, or distilled water) before the intramuscular HBV, while patients in group 6 received no intervention. The pain response in each group after the HBV injection was assessed and compared using cry duration and Douleur Aigue Nveau-ne (DAN) score, a behavioral acute pain rating scale for newborns. Results: Cry duration was decreased in all intervention groups, significantly so in the sucrose (19.90 seconds), breastfeeding (31.57 seconds), and nonnutritive sucking (36.93 seconds) groups compared with controls (52.86 seconds). DAN scores decreased significantly (P<0.05) at one or more points i.e. 30, 60, or 120 seconds in the breastfeeding and 25% sucrose intervention groups compared with controls. Conclusion: Oral sucrose and nonnutritive sucking are simple yet underutilized nonpharmacological interventions that effectively reduce pain in newborns.

키워드

참고문헌

  1. Merskey H, Bogduk N, editors. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle (WA): IASP Press, 1994.
  2. Fitzgerald M, McIntosh N. Pain and analgesia in the newborn. Arch Dis Child 1989;64(4 Spec No):441-3. https://doi.org/10.1136/adc.64.4_Spec_No.441
  3. Majcher TA, Means LJ. Pain management in children. Semin Pediatr Surg 1992;1:55-64.
  4. Reyes S. Nursing assessment of infant pain. J Perinat Neonatal Nurs 2003;17:291-303. https://doi.org/10.1097/00005237-200310000-00008
  5. Chiswick ML. Assessment of pain in neonates. Lancet 2000;355:6-8. https://doi.org/10.1016/S0140-6736(99)00392-X
  6. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, et al. Guidelines for procedural pain in the newborn. Acta Paediatr 2009;98:932-9. https://doi.org/10.1111/j.1651-2227.2009.01291.x
  7. Anand KJ; International Evidence-Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med 2001;155:173-80. https://doi.org/10.1001/archpedi.155.2.173
  8. Taddio A, Shah V, Hancock R, Smith RW, Stephens D, Atenafu E, et al. Effectiveness of sucrose analgesia in newborns undergoing painful medical procedures. CMAJ 2008;179:37-43. https://doi.org/10.1503/cmaj.071734
  9. Campos RG. Rocking and pacifiers: two comforting interventions for heelstick pain. Res Nurs Health 1994;17:321-31. https://doi.org/10.1002/nur.4770170503
  10. Gradin M, Finnstrom O, Schollin J. Feeding and oral glucose--additive effects on pain reduction in newborns. Early Hum Dev 2004;77:57-65. https://doi.org/10.1016/j.earlhumdev.2004.01.003
  11. Chermont AG, Falcao LF, de Souza Silva EH, de Cassia Xavier Balda R, Guinsburg R. Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants. Pediatrics 2009;124:e1101-7. https://doi.org/10.1542/peds.2009-0993
  12. Altman DG, Schulz KF. Statistics notes: Concealing treatment allocation in randomised trials. BMJ 2001;323:446-7. https://doi.org/10.1136/bmj.323.7310.446
  13. Doig GS, Simpson F. Randomization and allocation concealment: a practical guide for researchers. J Crit Care 2005;20:187-91. https://doi.org/10.1016/j.jcrc.2005.04.005
  14. Gray L, Watt L, Blass EM. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics 2000;105:e14. https://doi.org/10.1542/peds.105.1.e14
  15. Carbajal R, Veerapen S, Couderc S, Jugie M, Ville Y. Analgesic effect of breast feeding in term neonates: randomised controlled trial. BMJ 2003;326:13. https://doi.org/10.1136/bmj.326.7379.13
  16. Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics 2002;109:590-3. https://doi.org/10.1542/peds.109.4.590
  17. Yilmaz G, Gurakan B, Saatci U. Factors influencing the duration of crying of infants after heel lance. Cocuk Sagligi ve Hastaliklari Dergisi 2002;45:233-6.
  18. Ozdemir FK, Tufekci FG. The effect of using musical mobiles on reducing pain in infants during vaccination. J Res Med Sci 2012;17:662-7.

피인용 문헌

  1. Pain Control with Lavender Oil in Premature Infants: A Double-Blind Randomized Controlled Study vol.27, pp.2, 2020, https://doi.org/10.1089/acm.2020.0327