Neonatal acute pain with repeated painful stimuli, randomized trial comparing three analgesic non pharmacological methods
DOI:
https://doi.org/10.61651/rped.2009v62n1p08-14Keywords:
PainAbstract
Introduction: Non pharmacological methods are rarely used in neonatal units. repeated painful stimuli have long noxious effects.
Objective: To verify the effectiveness of non pharmacological methods in repeated painful procedures; to determine which method is more effective.
Material and methods: We conducted a randomized controlled trial. Newborns were randomly assigned into 3 groups (n=40 per group). All of them underwent painful procedures during the first 3 days of life (hepatitis B, BCG and blood sample for determine group and factor). Group A received breast feeding and skin to skin contact as non pharmacological method during the painful stimuli, group B received dextrose 10% and group C only suction. Douleur Aigue Nouveau-ne scores (DAN, Carvajal et al.) and ABC scale (Bellieni et al.) were used to assess neonatal pain. The 3 groups were compared in each stimulus to determine the most effective method, and the effectiveness in repeated painful stimuli.
Results: Group B showed the most analgesic effect in the 3 stimuli, with 97, 5% for NO PAIN vs. 87, 5% (A) and 85% (C) (p<0,036) with ABC scale, and 95% vs. 85% (A) and 70% (C) for NO PAIN with DAN scale (p<0,022). This difference was constant with all categories of pain. We observed that analgesic effect is greater in repeated painful stimuli. NO PAIN category was 70% in group B in the first stimuli, 85% in the second and 95% in third (p<0,020). This effect was also observed in groups A and C.
Conclusions: Dextrose 10% seems to offer the best analgesic effect compared with breast feeding and suction. Non pharmacological methods studied increase their effectiveness in repeated painful stimuli.
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