• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.388-393
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• 2006

Purpose : We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. Methods : Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. Results : There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A : $12.5{\pm}2.5$, B : $10.1{\pm}2.6$, C : $9.4{\pm}2.0$, D : $6.5{\pm}2.1$ and E : $8.7{\pm}2.3$; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A : 100 percent, B : 82 percent, C : 56 percent, D : 40 percent and E : 70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A : 72 percent, B : 30 percent, C : 22 percent, D : 0 percent and E : 14 percent; that of group D was clearly lowest. Conclusion : These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.

• Child Health Nursing Research
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• v.6 no.2
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• pp.144-157
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• 2000

This study was done to understand nonpharmacologic pain management for pediateric patients and nurses' knowledge and attitudes toward it. The aim of this study was that which method did the patient's use according to the nurses' age, and how did they effectively use these methods in their field. The subjects of this study were 77 nurses working in the Pediatric unit in the Kyung Medical Center from September 2 to 15, 1999 using questionnaire form. The results of this study were as follows : 1. We divided the subjects into four groups : Younger than one year old, 1-6 years, 6-12 years, 12-18 years group. In the group younger one year old, most of the nurses participating in this study used speaking in soft quiet tones, supportive touch, toys, pacifiers. In the group of 1-6 years, they used speaking in soft quiet tones, toys, distracting attention, story talking, and visual stimulus. In the group of 6-12 years. they used pop-up books, providing information, cold therapy, speaking in soft quiet tones, supportive touch. In the group of 12-19 years, most of them used providing information, controling respiration and supportive touch. 2. The effective nursing intervention used in their field are speaking in soft quiet tones, pacifiers and nesting with blanket in the group of younger than one year old. Un the group of 1-6 years old, speaking in soft quiet tones, toys, and supportive touch were effective method in the control of nonp-harmacologic pain management. In the group of 6-12 years old, story talking, supportive touch, and speaking in soft quiet tones were effective method and in the group of 12-18 years old, providing information, cold therapy and supportive touch were effectively used to control nonpharmacologic pain management. 3. To compare the general characteristics and non-pharmacologic pain nursing intervention, in the group of younger than one year, touching stimuli is widely used. In the groups of 1-6, and 6-12 years old, visual and audio method were widely used. In the group of 12-18 years old, sensitive intervention were used as well as education, information and guided imagery. In conclusion, there was no significant difference in nurses' demographic characteristics, child's age and nonpharmacologic pain management. There was significant difference only in the nurses working area, that is nurses working in the surgical department used more audio-visual-tactile pain management methods than medical department.

• Child Health Nursing Research
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• v.7 no.1
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• pp.35-50
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• 2001

The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotrans-mitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO₂. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25％ sucrose). Collected data were analyzed with the SAS program using X²-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25％ sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO₂: The SaO₂ score of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO₂ score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.

• Child Health Nursing Research
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• v.13 no.3
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• pp.299-307
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• 2007

Purpose: To investigate the effect of nonnutritive sucking(NNS) on the heart rate, oxygen saturation, and behavioral state of premature infants. Method: From December 15, 2004 to February 15, 2005, 20 premature infants hospitalized in the neonatal intensive care units were assigned to an experimental group (10), or a control group (10). Circular pacifiers for premature infants (Johnson, U.S.A.), which had been packed with $2{\times}2$ gauzes to create a vacuum, were used for 5 minutes, one hour after feeding for 5 days. Heart rates and oxygen saturation were checked every minute for 10 minutes once a day and behavioral states were monitored through video recording at the same time. Results: Changes in heart rate, oxygen saturation and behavioral state were found to show significant differences between the experimental group and the control group according to the point in time, and interactions were found between the group and the point of time. However, for behavioral state, no significant difference was found between the experimental group and the control group after the NNS was removed. Conclusion: From the results of this study it is possible to conclude that NNS is a positive intervention to bring about increased oxygen saturation and soothed behavioral state for premature infants.

• Child Health Nursing Research
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• v.7 no.2
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• pp.236-244
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• 2001

We studied the effects of nonnutritive sucking(NNS) on lingual lipase activity and body weight under bottle feeding with 17 premature infants hospitalized. NNS was applied to nine infants and other eight infants comprised the control group. Pacifiers were applied to the experimental group for 5 minutes before and after bottle feeding. The treatment took approximately 20-25 minutes each time including bottle feeding time and was applied 7 times a day at intervals of 3 hours and for consecutive ten days. Lingual lipase activity and body weight were measured on the first, third, seventh and tenth day. Results and Conclusion : 1. Lingual lipase activity was low at 30 minutes after feeding and then began to increase reaching its highest level at 120 and 180 minutes after the feeding in both group. 2. Lingual lipase activity in the experimental group was not higher than that of the control group on the third, seventh and tenth day. 3. Body weight increased in experimental and control groups as days passed, while it was not significantly different between groups. These results lead to conclusion that among premature infants under bottle feeding, NNS is not effective in increasing the lingual lipase for fat digestion and NNS is not also effective for increasing body weight. The application of NNS to premature infants under bottle feeding needs considerable judgement for promoting well-being of nursing goals.

• Child Health Nursing Research
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• v.25 no.3
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• Neonatal Medicine
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• v.18 no.2
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• pp.353-358
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• 2011

Purpose: The goal of this study was to compare the efficacy of oral 25% dextrose treatment or/and pacifier for analgesia in healthy newborns during intramuscular injection of a hepatitis B vaccine. Methods: A prospective, randomized, partially blinded, clinical trial was performed in 132 healthy newborns. They were assigned randomly to 4 treatment groups: control group (2 mL distilled water), dextrose group (2 mL 25% dextrose), pacifier group, dextrose+pacifier group (pacifier coating with 25% dextrose) during intramuscular injection of hepatitis B vaccine. For all groups, Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) scores were evaluated before the injection, during the injection, and at 2 minutes after the injection. Pain scores were compared among the 4 groups. Results: Maternal and neonatal characteristics were similar among the 4 groups. 25% dextrose treatment led to lower NIPS pain scores during injection (6.4${\pm}$0.9 vs. 5.5${\pm}$1.7, P=0.01) and after injection (1.6${\pm}$2.0 vs. 0.6${\pm}$0.9, P=0.01) and NFCS pain scores after injection (1.5${\pm}$2.3 vs. 0.7${\pm}$0.8, P=0.04) than control group. The number of neonates who feel the pain (indication of scores: NIPS${\geq}$4, NFCS${\geq}$3) decreased (9 (23.1%) vs. 0 (0%), P=0.04 via NIPS, 7 (17.9%) vs. 0 (0%), P=0.02 via NFCS). However, all treatment groups did not decreased PIPP scores, compared with the control group. Conclusion: Oral 25% dextrose is effective than distilled water or using pacifier with or without 25% dextrose in reducing pain during intramuscular injection of hepatitis B vaccinations. Further study based on this preliminary study need about nonpharmacologic management of pain in newborns.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.91-100
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• 2010

Purpose : Recurrent otitis media (ROM) is usually defined as ${\geq}$3 distinct and well-documented episodes within 6 months or ${\geq}$4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. Methods : This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. Results : Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. Conclusion : Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.