Effectiveness of Gentle Human Touch for Pain Control During Examination for Retinopathy of Pre-maturity: A Randomized Controlled Trial

Abstract

Background: Retinopathy of pre-maturity (ROP) is a disorder of the retinal blood vessels in pre-term infants with low birth weight. It is a leading cause of blindness in children. During ROP screening, the use of mydriatic drops and eyelid openers causes pain and discomfort. Pain management strategies include medications and behavioral interventions. The objectives of this study was to investigate the effects of Gentle Human Touch on pain in pre-term infants undergoing screening for ROP.Methods: In this randomized controlled trial, 82 infants in the neonatal intensive care unit at Children's Hospital of Nanjing Medical University who met the ROP screening criteria were randomly assigned to experimental and control groups using the random number table. The infants in the experimental group continuously received Gentle Human Touch during screening, while those in the control group were screened according to the routine procedure. All neonates were administered local eye anesthesia before the screening. The degree of pain was assessed using the Pre-mature Infant Pain Profile score. A double-channel near-infrared spectroscopy device was used to monitor regional cerebral oxygen saturation (rScO2), while oxygen saturation (SaO2) and heart rate were measured using pulse oximetry. The Pre-mature Infant Pain Profile score was the primary outcome, while heart rate, SaO2, and rScO2 were the secondary outcomes.Results: The gestational age, corrected gestational age, birth weight, and Apgar score at examination and the basal heart rate, SaO2, and rScO2 showed no significant intergroup differences (P > 0.05 for all). Both groups demonstrated significant decreases in SaO2 and rScO2 in response to the examination (P < 0.05 for all). During the examination, the Pre-mature Infant Pain Profile score (14.82 ± 3.22 vs. 9.29 ± 2.89, respectively; P < 0.05) was significantly higher in the control group than in the experimental group, while rScO2 (57.61 ± 3.51 vs. 54.76 ± 4.54%, respectively; P < 0.05) and SaO2 (91.89 ± 6.43 vs. 85.68 ± 8.31%; P < 0.05) were significantly higher in the experimental group than in the control group. There was no significant difference in heart rate changes between the two groups before and after the examination (182.60 ± 3.50 vs. 170.80 ± 3.50 time/min; P > 0.05).Conclusions: The findings of this study suggest that Gentle Human Touch can effectively alleviate pain during ROP screening in pre-mature infants.Clinical Trial Registration: ISRCTN10976481, Registered 06 March 2020, Retrospectively registered.

Effects of white noise on procedural pain-related cortical response and pain score in neonates: A randomized controlled trial

“…It is of great importance to evaluate the effect of interventions on pain-related neurobiology-based parameters in neonates [ 4 ]. In the present study, there were significant changes in both groups in rScO 2 after the needle penetrating the skin, which was similar to a previous study [ 37 ]. Painful stimuli in neonates activated nociceptive pathways from the periphery to the cortex, as a result, the cerebral oxygen consumption increased and the rScO 2 decreased.…”

The effectiveness of massage interventions on procedural pain in neonates: A systematic review and meta-analysis

“…The 11 studies were published between 2006 and 2021 written in English, and the characteristics were summarized in Table 1 . They were carried out in 5 different countries, 2 in China, [ 33 , 40 ] 4 in Iran, [ 37 , 39 , 41 , 42 ] 1 in Korea, [ 34 ] 2 in Canada, [ 17 , 35 ] and 2 in Turkey. [ 36 , 38 ] Five studies [ 34 , 36 – 38 , 41 ] included neonates gestational age older than 37 weeks.…”

“…Included studies evaluated different painful procedures during hospitalization including venipuncture (n = 1), [ 33 ] hypothyroidism screening (n = 1), [ 37 ] heel-prick (n = 7), [ 17 , 34 – 36 , 38 , 39 , 41 ] screening for retinopathy (n = 1), [ 40 ] and endotracheal suctioning (n = 1). [ 42 ]…”

“…The risk of incomplete outcome data was high in only one study, [ 42 ] because the missing date of different groups was unbalanced and the reasons were different. For selective reporting, four studies [ 36 , 37 , 39 , 42 ] were judged low but one [ 40 ] was high risk since not all of the prespecified outcomes were reported. Of all the studies, we considered only four [ 33 , 38 , 41 , 42 ] to be free from the bias of other sources, and others unclear for insufficient evidence provided.…”

Efectos del tacto terapéutico en el recién nacido prematuro con CPAP nasal: una prueba piloto

“…Los cuidados de enfermería en el RNPT deben estar centrados en el desarrollo, lo que se traduce en cierto modo a proporcionar cuidados lo más fisiológicos posibles y apropiados, que eviten alteraciones anatomo-fisiológicas especialmente en el sistema cardiorrespiratorio y neurológico 12 . Los cuidados centrados en el desarrollo del RNPT se orientan en proporcionar intervenciones durante su atención, estas estrategias van dirigidas al control de la estimulación lumínica y sonora excesivas, el establecimiento del principio de mínima manipulación 13 , estrategias para el control del dolor como la succión no nutritiva y nutritiva con sacarosa y leche materna, estrategias de contacto como el método madre canguro y el contacto humano suave 14 .…”