P Thakkar1, K Arora2, K Goyal1, R R Das3, B Javadekar1, S Aiyer1, S K Panigrahi4. 1. Department of Paediatrics, Government Medical College and Hospital, Vadodara, India. 2. Division of Neonatology, Department of Paediatrics, Dayanand Medical College and Hospital, Ludhiana, India. 3. Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, India. 4. Department of Community Medicine, IMS and SUM Hospital, Bhubaneswar, India.
Abstract
OBJECTIVE: The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking (NNS) for analgesia in newborn infants undergoing heel-stick procedures. STUDY DESIGN: This randomized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year. One hundred and eighty full-term neonates with birth weight >2200 g and age >24 h were randomized to one of four interventions administered 2 min before the procedure: 2 ml of 30% sucrose (group I, n=45) or NNS (group II, n=45) or both (group III, n=45) or none (group IV, n=45). Primary outcome was composite score based on Premature Infant Pain Profile (PIPP) score. RESULT: Baseline variables were comparable among the groups. Median (interquartile range) PIPP score was 3 (2 to 4) in group III as compared with 7 (6.5 to 8) in group I, 9 (7 to 11) in group II and 13 (10.5 to 15) in group IV. Group III had significant decrease in the median PIPP score compared with other groups (P=0.000). Median PIPP score also decreased significantly with any intervention as compared with no intervention (P=0.000). CONCLUSION:Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.
RCT Entities:
OBJECTIVE: The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking (NNS) for analgesia in newborn infants undergoing heel-stick procedures. STUDY DESIGN: This randomized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year. One hundred and eighty full-term neonates with birth weight >2200 g and age >24 h were randomized to one of four interventions administered 2 min before the procedure: 2 ml of 30% sucrose (group I, n=45) or NNS (group II, n=45) or both (group III, n=45) or none (group IV, n=45). Primary outcome was composite score based on Premature InfantPain Profile (PIPP) score. RESULT: Baseline variables were comparable among the groups. Median (interquartile range) PIPP score was 3 (2 to 4) in group III as compared with 7 (6.5 to 8) in group I, 9 (7 to 11) in group II and 13 (10.5 to 15) in group IV. Group III had significant decrease in the median PIPP score compared with other groups (P=0.000). Median PIPP score also decreased significantly with any intervention as compared with no intervention (P=0.000). CONCLUSION:Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.
Authors: Cian Wade; John Scott Frazer; Evelyn Qian; Lien M Davidson; Suzanne Dash; Anna Te Water Naudé; Rema Ramakrishan; Jalemba Aluvaala; Kokila Lakhoo; Mike English Journal: Lancet Child Adolesc Health Date: 2020-07-28