Efficacy of Mechanical Vibration of Heel Stick Pain in Neonates

Abstract

Amaç: Topuk kanı alınması işlemi; yenidoğanların hastanede kaldığı sürede en sık uygulanan ağrılı girişimlerdendir. Mekanik vibrasyon yenidoğan ağrı kontrolünde tercih edilebilecek invaziv olmayan, ucuz ve kolay uygulanabilir bir yöntemdir. Çalışmamız yenidoğanlarda topuk delme işlemi sırasında oluşabilecek ağrı hissini engellenmek için mekanik vibrasyon uygulamasının etkinliğini test etmek amacıyla yapılmıştır. Yöntem: Araştırma randomize kontrollü, tek merkezli prospektif bir çalışma olarak Medeniyet Üniversitesi Göztepe Eğitim Araştırma Hastanesi'nde, 37-42 GH' nda doğan sağlıklı term 60 yenidoğanda, Eylül 2012-Mart 2013 tarihleri arasında yapılmıştır. Çalışma alınma kriterlerini karşılayan yenidoğanların ebeveynlerinden onam alınmıştır. Topuk delme işlemi her yenidoğana yapılan fenilketonüri testi sırasında uygulanmıştır. Hastaların tamamının demografik özellikleri, işlem sürecindeki KTA, SPO2, vücut ısısı ölçümleri kaydedilmiştir. Tüm uygulamalar kameraya kaydedilmiş, sonrasında görüntüler izlenerek araştırmacı tarafından NIPS skorlaması yapılmıştır. Bu çalışmada NIPS puanlama sisteminin Cronbach's alpha katsayısı işlem sırası için .85, işlem sonrası için .87 olarak bulunmuştur. Bulgular: Deney grubunun NIPS puan ortalaması işlem sırası ve işlem sonrası için (0,967±1,771) ve (1,733±2,050), kontrol grubunda ise sırası ile (3,567±1,775) ve (4,533±1,907) olarak belirlenmiştir (p<0,05). Her iki gruptaki yenidoğanların işlem sonrası NIPS puan sonuçları işlem sırasındakilerden istatistiksel olarak anlamlı yüksek bulunmuştur (p<0,05). Sonuç: Yenidoğanlarda ağrı algısının azaltılmasında ve ağrı kontrolünde mekanik vibrasyon yöntemi etkili bulunmuştur. AbstractObjective: One of the most frequently observed painful procedures during newborn hospitalization is the neonatal heel prick. The use of vibration therapy in newborn pain control can be a preferred method for its non-invasive, cheap, and easy applicability. This study aimed to evaluate effectiveness of mechanical vibration application to avoid pain sensation during heel puncture in newborns. Methods: This was a prospective single-center, placebo-controlled,, prospective randomized study. The study sample composed of healthy neonates born between 37 and 42 weeks of gestation in Medeniyet University Göztepe Training and Research Hospital. Sixty healthy neonates born in the study hospital between September 2012 and March 2013 and who matched the inclusion criteria after parental consent was obtained were included in the study. Heel puncture was applied to the infants during routine testing for phenylketonuria. It was recorded that all of the newborns demographic characteristics, heart rate,oxygen saturation and body tempature measurement at the process. All applications was saved to video camera, then displayed followed and the NIPS was scored by the investigator. The Cronbach's alpha coefficient for the NIPS scoring system was 0.85 during the procedure and 0.87 after the procedure in this study. Results: Before procedure and during procedure the NIPS point average...

The Effect of Vibration on Pain During Heel Lance Procedures in Newborns

“…However, very few studies have investigated the effectiveness of vibration therapy in alleviating pain during heel lance procedures in newborns 18. The current study has provided similar results to previous clinical studies that found that the pain threshold increased as a result of the vibration 15,16,18. In a study by McGinnis et al,16 the heels of the newborns in the control group were warmed with a heel warmer 3 to 5 minutes before the heel lance procedures, and the newborns were given 0.1- to 0.2-mL oral 24% sucrose with a pacifier 2 minutes before the procedures.…”

“…The efficacy of mechanical vibration for relieving pain in newborns has been shown in clinical studies 15–18. However, very few studies have investigated the effectiveness of vibration therapy in alleviating pain during heel lance procedures in newborns 18.…”

“…18 The current study has provided similar results to previous clinical studies that found that the pain threshold increased as a result of the vibration. 15,16,18 In a study by McGinnis et al, 16 the heels of the newborns in the control group were warmed with a heel warmer 3 to 5 minutes before the heel lance procedures, and the newborns were given 0.1-to 0.2-mL oral 24% sucrose with a pacifier 2 minutes before the procedures. The same steps were performed for the experimental group while applying vibration to the middle/side area through which the sural nerve passes immediately below the knee of the limb from which the heel blood was to be collected nearly 30 minutes before and throughout the procedures.…”

“…The efficacy of mechanical vibration for relieving pain in newborns has been shown in clinical studies. [15][16][17][18] However, very few studies have investigated the effectiveness of vibration therapy in alleviating pain during heel lance procedures in newborns. 18 The current study has provided similar results to previous clinical studies that found that the pain threshold increased as a result of the vibration.…”

“…G Power software was used to calculate the sample size of the study. Power analysis was performed using the findings of Dolu Kaya and Karakoç 15 for the pain scores of the vibration group (4.533 ± 1.907) and the control group (1.733 ± 2.050), after the heel lance procedures had been done on the newborns. As a result of the power analysis, it was determined that 50 infants should be included, with 25 in each group (comparisons of the means of the 2 groups included type I error: 0.01, type II error: 0.10, and power of the test: 0.90).…”