Ananda Fernandes1, Celeste Johnston2
1) Portugal 2) Canada
Background and aims: Preterm neonates in intensive care units endure frequent diagnostic and treatment procedures that may cause pain. Interventions that will decrease pain in these neonates are needed. Both sucrose and kangaroo care are known to be effective interventions to reduce procedural pain in neonates. However, the effect of the combination is unknown. The aim of this study was to compare the efficacy of the combination of sucrose and kangaroo care (S+KC), with that of sucrose alone (S), in reducing the pain responses of preterm infants undergoing venipuncture.
Methods: A randomized, single-blind, controlled trial was conducted in two neonatal intensive care units in Portugal. Preterm neonates (n=110), stratified by gestational age (28-316/7 and 32-366/7), were randomly assigned to receive S+KC (skin-to-skin care on mother’s chest) or S for venipuncture. Measures of pain responses were the Premature Infant Pain Profile (PIPP) and recovery time. Physiological variables were recorded continuously. Facial actions were video recorded and coded blindly. Main statistical analysis was conducted using a two-factor repeated-measures ANOVA with intervention as between-subjects factor and phase of procedure as within-subjects factor.
Results: Although no difference was found between groups on the PIPP, infants in S+KC displayed significantly less facial actions (brow bulge and eye squeeze) compared to infants in S; they were more likely to have recovered heart rate baseline values at 60 and 90 seconds after the procedure if they were 32 weeks gestational age or above; and were more likely to be asleep during the procedure. No adverse events occurred that needed intervention.
Conclusion: Combining kangaroo care and sucrose is safe and more effective than sucrose alone to reduce pain responses in preterm infants 28-36 weeks undergoing venipuncture.