Jaya Upadhyay1, Sourabh Kumar1, Poonam Singh1, Sriparna Basu2. 1. Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India. 2. Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India. sriparna.neonat@aiimsrishikesh.edu.in.
Abstract
OBJECTIVE: The present study evaluated the pain perception in preterm neonates during insertion of orogastric (OG) vs. nasogastric (NG) tube by measuring the cerebral regional oxygen saturation (crSO2) and premature infant pain profile-revised (PIPP-R) score. STUDY DESIGN: Randomized controlled cross-over trial. RESULTS: Fifty infants of mean (SD) gestational age of 31.54(2) and 31.64(2.2) weeks, birth weight of 1362(354) and 1507(365) grams were randomized into OG/NG (n = 25) and NG/OG (n = 25) sequences. Mean post-menstrual age at assessment was 33(2.8) and 33(1.5) weeks, and the difference between two interventions was 1.08(0.5) and 1.12(0.5) days in OG-NG and NG-OG, respectively. Mean crSO2(%) during insertion was significantly lower with NG compared to OG route. Mean PIPP-R score, heart rate variability, time to normalize crSO2, and the duration of cry were also significantly higher with NG insertion. CONCLUSIONS: Compared to OG, NG route of feeding tube insertion was associated with higher fluctuations in crSO2 and higher PIPP-R scores. CLINICAL TRIAL REGISTRY OF INDIA (CTRI) REGISTRATION NO: CTRI/2020/03/023728.
OBJECTIVE: The present study evaluated the pain perception in preterm neonates during insertion of orogastric (OG) vs. nasogastric (NG) tube by measuring the cerebral regional oxygen saturation (crSO2) and premature infant pain profile-revised (PIPP-R) score. STUDY DESIGN: Randomized controlled cross-over trial. RESULTS: Fifty infants of mean (SD) gestational age of 31.54(2) and 31.64(2.2) weeks, birth weight of 1362(354) and 1507(365) grams were randomized into OG/NG (n = 25) and NG/OG (n = 25) sequences. Mean post-menstrual age at assessment was 33(2.8) and 33(1.5) weeks, and the difference between two interventions was 1.08(0.5) and 1.12(0.5) days in OG-NG and NG-OG, respectively. Mean crSO2(%) during insertion was significantly lower with NG compared to OG route. Mean PIPP-R score, heart rate variability, time to normalize crSO2, and the duration of cry were also significantly higher with NG insertion. CONCLUSIONS: Compared to OG, NG route of feeding tube insertion was associated with higher fluctuations in crSO2 and higher PIPP-R scores. CLINICAL TRIAL REGISTRY OF INDIA (CTRI) REGISTRATION NO: CTRI/2020/03/023728.