Effect of non-nutritive sucking and leg massage on physiological and behavioral indicators of pain following heel blood sampling in term neonates

Abstract

Background: Pain management is especially important for neonates who are not able to verbally express their pain. Non-pharmacological pain management method as an alternative to pharmacological pain medication has increased nowadays. Objectives: The purpose of this study was to test the effect of leg massage and non-nutritive sucking (NNS) on reducing the pain that neonates experience when undergoing the heel stick procedure for blood testing. Methods: This investigation was a random controlled clinical trial study on ninety neonates who were selected randomly among admitted neonates to NICU in Alavi hospital at Ardabil. The subjects were randomly classified in two case and one control groups. The neonates received leg massage (n=30), NNS (n=30), and no intervention (n=30) respectively. Measurements of HR and SaO2 were taken twice: once before and then again after intervention. Pain response was measured by the PIPP scale. Results:The study showed that the HR of the three groups significantly increased after heel stick compared to before heel stick. The change of SaO2 levels in NNS groups was lower than the control and massage groups. The change of PIPP scores in massage and NNS groups was lower than that of the control group; however, there was not statistically significant differences between NNS & massage groups(p=0.91) Conclusion: pain management and pain relief in the infant is an important issue in neonatal health care. It is suggested that the single or combined use of massage and a pacifier is effective in reducing pain responses in neonates undergoing heel stick.

Analgesic effect of non-nutritive sucking in term neonates: A randomized controlled trial

“…These findings were consistent with previous studies in the area exploring multiple pain stimuli and pain assessment tools. For instance, Mirzarahimi M et al (2013) reported the efficacy of NNS in alleviating pain during heel blood sampling in term neonates using the PIPP pain score, when compared to the control group. 15 Another RCT by Liaw JJ et al (2011) also showed that the NFCS pain scores in infants receiving NNS were lower compared to the control group during intramuscular injections for hepatitis vaccination.…”

“…For instance, Mirzarahimi M et al (2013) reported the efficacy of NNS in alleviating pain during heel blood sampling in term neonates using the PIPP pain score, when compared to the control group. 15 Another RCT by Liaw JJ et al (2011) also showed that the NFCS pain scores in infants receiving NNS were lower compared to the control group during intramuscular injections for hepatitis vaccination. 18 16 Similarly, the NIPS pain scores in infants receiving NNS during venipunctures was lower than those in the control group in a 2010 study by Liu M et al 19 In contrast, Kristoffersen et al revealed that infants in the control group had lower PIPP pain scores than those receiving NNS during a feeding tube insertion procedure.…”

“Empeng” Efektif Menurunkan Nyeri Bayi saat Pengambilan Darah Vena

“…Teori tersebut menyatakan bahwa pada masa neonatus, BBLR berada pada tahap perkembangan oral, sehingga penghisapan akan memberikan rasa nyaman. Keterbatasan intervensi pemberian empeng adalah kurang menerapkan prinsip family centered care (Mirzarahimi, Mehrnoush, Shahizadeh, Samadi, & Amani, 2013).…”

“…Pelaksanaan intervensi pemberian empeng dipengaruhi oleh rasa lapar, ketidaknyamanan, temperamen BBLR, status bangun dan tidur, serta pengalaman nyeri (Mirzarahimi et al, 2013).…”

The Effect of Non-nutritive Sucking by Mothers on Full Oral Feeding Attainment in Preterm Neonates

“…In 1998, the American Academy of Pediatrics declared full oral feeding tolerance as a discharge criterion (14). Today, several studies are conducted on NNS in preterm neonates to maximally speed up independent oral feeding (15)(16)(17)(18). Non-nutritive feeding during gavage increases the secretion of digestive enzymes and improves digestion (12,19,20).…”