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Investigation of The Effects of Two Nonpharmacological Methods; Using Pacifiers and Maternal Holding, On Pain of Neonates in The Outpatient Clinic and Neonatal Intensive Care Unit

Year 2022, Volume: 12 Issue: 1, 33 - 37, 15.01.2022
https://doi.org/10.16899/jcm.928100

Abstract

Introduction: The most important purpose in neonatal pain management is to minimize the pain felt by newborns and to help the newborn cope with pain. This study planned to examine the effects of two non-pharmacological methods, using pacifiers or maternal holding, on neonates’ pain admitted to the outpatient clinic (OC) and hospitalized in the Neonatal Intensive Care Unit (NICU).
Material and Methods: Ninety newborns (30 used pacifiers, 30 maternal holding,30 control) who applied to the OC and 60 newborns (30 used pacifiers, 30 control) admitted to the NICU were prospectively included in this study. The Neonatal Infant Pain Scale (NIPS) was used to evaluate behavioral responses to pain perception. Physiological parameters of newborns and their durations of crying were also evaluated.
Results: When the NIPS scores were analyzed in OC group during and after the procedure, the lowest score was found in the group using pacifiers (p<0.001). As for the NICU patients, both during and after the procedure, NIPS scores were found to be significantly lower in the pacifier users (p<0.001). It was observed that giving pacifiers and mathernal holding had positive effects on physiological parameters and duration of crying in OC patients (p<0.05). No significant difference in the NIPS score was found between OC and NICU group.
Conclusion: This study showed that giving pacifiers and maternal holding during the procedure of blood sampling decreased the NIPS score, restored the changes in physiological parameters and decreased the duration of crying.

References

  • 1. Smith RP, Gitau R, Glover V et al. Pain and stress in the human fetus. European Journal of Obstetrics&Gynecology and Reproductive Biology 2000;92:161-5.
  • 2. Perry M, Tan Z, Chen J et al. Neonatal Pain: Perceptions and Current Practice. Crit Care Nurs Clin North Am. 2018;30(4):549-61.
  • 3. Simons SHP, Tibboel D. Pain perception development and maturation. Seminars in Fetal&Neonatal Medicine 2006;11:227-31.
  • 4. Walker SM. Long-term effects of neonatal pain. Semin Fetal Neonatal Med. 2019 ;24(4):101005. doi: 10.1016/j.siny.2019.04.005.
  • 5. Cong X, Wu J, Vittner D et al. The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU. Early Hum Dev 2017;108:9-16
  • 6. Committee on fetus and newborn and section on anesthesiology and pain medicine. Prevention and Management of Procedural Pain in the Neonate: An Update. Pediatrics. 2016;137(2):e20154271.
  • 7. Squillaro A, Mahdi EM, Tran N et al. Managing Procedural Pain in the Neonate Using an Opioid-sparing Approach. Clin Ther. 2019;41(9):1701-13
  • 8. Field T. Preterm newborn pain research review. Infant Behav Dev. 2017;49:141-50.
  • 9. Dur S, Balci S. Assessing Neonatal Pain, Duration of Crying and Procedure Time following Use of Automatic or Manual Heel Lances: A Randomized Controlled Study. J Trop Pediatr 2018;64(6):488-94.
  • 10. Harrison D, Reszel J, Bueno M et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev. 2016;10(10):CD011248. doi: 10.1002/14651858.CD011248.pub2.
  • 11. Cignacco E, Hamers JPH, Stoffel L et al. The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates. A systematic literature review. European Journal of Pain 2007;11:139-52.
  • 12. Lawrence J, Alcock D, McGrath P et al. The devolopment of a tool to assess neonatal pain. Neonatal Network 1993;12(6):59-64.
  • 13. Campos RG. Rocking and pacifiers: Two comforting interventions for heelstick pain. Res Nurs Health 1994;17(5):321-31.
  • 14. Corbo MG, Mansi G, Stagni A et al. Nonnutritive Sucking during Heelstick Procedures Decreases Behavioral Distress in the Newborn Infant. Biology of the Neonate 2000:77(3):162-167.
  • 15. Liaw JJ, Zeng WP, Yang L et al. Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine. Journal of Pain&Symptom Management 2011;42:918-30.
  • 16. Akdovan T. Sağlıklı yenidoğanlarda ağrının değerlendirilmesi, emzik verme ve kucağa alma yönteminin etkisinin incelenmesi (Tez). İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü; 1999.
  • 17. Merenstein GB, Gardner SL. Handbook of neonatal intensive care. 4th ed. Mosby, St. Louis, MO; 1998.
  • 18. Phillips RM, Chantry CJ, Gallagher MP. Analgesic effects of breast-feeding or pacifier use with maternal holding in term infants. Ambul Pediatr 2005;5(6):359-64.
  • 19. Stevens B, Yamada J, Ohlsson A et al. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2016;7(7):CD001069. doi: 10.1002/14651858.CD001069.pub5.
  • 20. Yiğit Ş, Ecevit A, Köroğlu ÖA. Turkish Neonatal Society guideline on the neonatal pain and its management. Turk Arch Pediatr 2018; 53:161-71

Sağlam Çocuk Polikliniğinde ve Yenidoğan Yoğun Bakım Ünitesinde Farmakolojik Olmayan Ağrı Giderme Yöntemlerinden Emzik Verme ve Anne Kucağının Yenidoğan Ağrısı Üzerine Etkisinin İncelenmesi

Year 2022, Volume: 12 Issue: 1, 33 - 37, 15.01.2022
https://doi.org/10.16899/jcm.928100

Abstract

Amaç: Yenidoğan ağrı yönetiminde en önemli amaç, yenidoğanların hissettiği ağrıyı en aza indirmek ve yenidoğanın ağrı ile baş etmesine yardım etmektir. Bu çalışmada non-farmakolojik yöntemlerden emzik verme ve anne kucağının yenidoğanda ağrı üzerine etkilerini incelemek amaçlandı.
Yöntem: Sağlam çocuk polikliniğine ayaktan başvuran 90 yenidoğan (30 emzik, 30 anne kucağı, 30 kontrol) ve aynı dönemde yenidoğan yoğun bakım ünitesinde(YYBÜ) yatarak izlenen 60 yenidoğan (30 emzik, 30 kontrol) çalışmaya dahil edildi. Ağrıya davranışsal yanıtları değerlendirmede Yenidoğan Bebek Ağrı Ölçeği (NIPS) kullanıldı. Ayrıca yenidoğanların fizyolojik parametreleri ile ağlama süreleri de değerlendirildi.
Bulgular: Sağlam çocuk grubunda NIPS skoru işlem sırasında ve sonrasında değerlendirildiğinde emzik verilen grupta en düşük bulundu (p<0,001). YYBÜ grubunda işlem sırasında ve sonrasında NIPS skorunun emzik verilen grupta anlamlı olarak düşük olduğu saptandı (her ikisinde p<0,001). Emzik verilen grupta daha belirgin olmak üzere emzik verme ve anne kucağının fizyolojik parametreler ve ağlama süreleri üzerine olumlu etkileri olduğu görüldü (p<0,05). Sağlam çocuk ve YYBÜ grubu arasında NIPS skorunda anlamlı bir fark bulunmadı.
Sonuç: Çalışmamızda yenidoğana ağrılı işlem sırasında emzik vermenin ve anne kucağının NIPS skorunu azalttığı, fizyolojik parametrelerdeki değişimi düzelttiği ve ağlama süresini azalttığı görüldü.

References

  • 1. Smith RP, Gitau R, Glover V et al. Pain and stress in the human fetus. European Journal of Obstetrics&Gynecology and Reproductive Biology 2000;92:161-5.
  • 2. Perry M, Tan Z, Chen J et al. Neonatal Pain: Perceptions and Current Practice. Crit Care Nurs Clin North Am. 2018;30(4):549-61.
  • 3. Simons SHP, Tibboel D. Pain perception development and maturation. Seminars in Fetal&Neonatal Medicine 2006;11:227-31.
  • 4. Walker SM. Long-term effects of neonatal pain. Semin Fetal Neonatal Med. 2019 ;24(4):101005. doi: 10.1016/j.siny.2019.04.005.
  • 5. Cong X, Wu J, Vittner D et al. The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU. Early Hum Dev 2017;108:9-16
  • 6. Committee on fetus and newborn and section on anesthesiology and pain medicine. Prevention and Management of Procedural Pain in the Neonate: An Update. Pediatrics. 2016;137(2):e20154271.
  • 7. Squillaro A, Mahdi EM, Tran N et al. Managing Procedural Pain in the Neonate Using an Opioid-sparing Approach. Clin Ther. 2019;41(9):1701-13
  • 8. Field T. Preterm newborn pain research review. Infant Behav Dev. 2017;49:141-50.
  • 9. Dur S, Balci S. Assessing Neonatal Pain, Duration of Crying and Procedure Time following Use of Automatic or Manual Heel Lances: A Randomized Controlled Study. J Trop Pediatr 2018;64(6):488-94.
  • 10. Harrison D, Reszel J, Bueno M et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev. 2016;10(10):CD011248. doi: 10.1002/14651858.CD011248.pub2.
  • 11. Cignacco E, Hamers JPH, Stoffel L et al. The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates. A systematic literature review. European Journal of Pain 2007;11:139-52.
  • 12. Lawrence J, Alcock D, McGrath P et al. The devolopment of a tool to assess neonatal pain. Neonatal Network 1993;12(6):59-64.
  • 13. Campos RG. Rocking and pacifiers: Two comforting interventions for heelstick pain. Res Nurs Health 1994;17(5):321-31.
  • 14. Corbo MG, Mansi G, Stagni A et al. Nonnutritive Sucking during Heelstick Procedures Decreases Behavioral Distress in the Newborn Infant. Biology of the Neonate 2000:77(3):162-167.
  • 15. Liaw JJ, Zeng WP, Yang L et al. Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine. Journal of Pain&Symptom Management 2011;42:918-30.
  • 16. Akdovan T. Sağlıklı yenidoğanlarda ağrının değerlendirilmesi, emzik verme ve kucağa alma yönteminin etkisinin incelenmesi (Tez). İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü; 1999.
  • 17. Merenstein GB, Gardner SL. Handbook of neonatal intensive care. 4th ed. Mosby, St. Louis, MO; 1998.
  • 18. Phillips RM, Chantry CJ, Gallagher MP. Analgesic effects of breast-feeding or pacifier use with maternal holding in term infants. Ambul Pediatr 2005;5(6):359-64.
  • 19. Stevens B, Yamada J, Ohlsson A et al. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2016;7(7):CD001069. doi: 10.1002/14651858.CD001069.pub5.
  • 20. Yiğit Ş, Ecevit A, Köroğlu ÖA. Turkish Neonatal Society guideline on the neonatal pain and its management. Turk Arch Pediatr 2018; 53:161-71
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Ramazan Gurlu 0000-0002-0198-721X

Dilek Kahvecioğlu 0000-0002-9081-5902

Hatice Tatar Aksoy 0000-0002-6471-4008

Arzu Yılmaz 0000-0003-2892-5104

Bulent Alioglu 0000-0002-1086-780X

Publication Date January 15, 2022
Acceptance Date October 21, 2021
Published in Issue Year 2022 Volume: 12 Issue: 1

Cite

AMA Gurlu R, Kahvecioğlu D, Tatar Aksoy H, Yılmaz A, Alioglu B. Investigation of The Effects of Two Nonpharmacological Methods; Using Pacifiers and Maternal Holding, On Pain of Neonates in The Outpatient Clinic and Neonatal Intensive Care Unit. J Contemp Med. January 2022;12(1):33-37. doi:10.16899/jcm.928100