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Pain Control Interventions in Preterm Neonates: A Randomized Controlled Trial

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Abstract

Objectives

To compare individual efficacy and additive effects of pain control interventions in preterm neonates.

Design

Randomized controlled trial

Setting

Level-3 University affiliated neonatal intensive care unit.

Participants

200 neonates (26-36 wk gestational age) requiring heel-prick for bedside glucose assessment. Exclusion criteria were neurologic impairment and critical illness precluding study interventions.

Intervention

Neonates were randomly assigned to Kangaroo mother care with Music therapy, Music therapy, Kangaroo Mother care or Control (no additional intervention) groups. All groups received expressed breast milk with cup and spoon as a baseline pain control intervention.

Main outcome measure

Assessment of pain using Premature Infant Pain Profile (PIPP) score on recorded videos.

Results

The mean (SD) birth weight and gestational age of the neonates was 1.9 (0.3) kg and 34 (2.3) wk, respectively. Analysis of variance showed significant difference in total PIPP score across groups (P<0.001). Post-hoc comparisons using Sheffe’s test revealed that the mean (SD) total PIPP score was significantly lower in Kangaroo mother care group [7.7 (3.9) vs. 11.5 (3.4), 95% CI(–5.9, –1.7), P<0.001] as well as Kangaroo mother care with Music therapy group [8.5 (3.2) vs. 11.5 (3.4), 95%CI (–5.1, –0.9), P=0.001] as compared to Control group. PIPP score was not significantly different between Control group and Music therapy group.

Conclusions

Kangaroo mother care with and without Music therapy (with expressed breast milk) significantly reduces pain on heel-prick as compared to expressed breast milk alone. Kangaroo mother care with expressed breast milk should be the first choice as a method for pain control in preterm neonates.

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Authors and Affiliations

  1. Division of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Vivek V. Shukla

  2. Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

    Satvik Bansal, Apurva Chapla, Dipen Patel & Somashekhar Nimbalkar

  3. Department of Physiology, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India

    Archana Nimbalkar

  4. Central Research Services, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India

    Ajay Phatak

Authors
  1. Vivek V. Shukla
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  2. Satvik Bansal
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  3. Archana Nimbalkar
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  4. Apurva Chapla
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  5. Ajay Phatak
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  6. Dipen Patel
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  7. Somashekhar Nimbalkar
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Correspondence to Vivek V. Shukla.

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Shukla, V.V., Bansal, S., Nimbalkar, A. et al. Pain Control Interventions in Preterm Neonates: A Randomized Controlled Trial. Indian Pediatr 55, 292–296 (2018). https://doi.org/10.1007/s13312-018-1270-z

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  • DOI: https://doi.org/10.1007/s13312-018-1270-z

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