Pain Control Interventions in Preterm Neonates: A Randomized Controlled Trial.

Area of Science:

• Neonatal care
• Pain management
• Developmental pediatrics

Background:

• Preterm neonates experience significant pain during routine procedures like heel-prick.
• Effective pain management is crucial for the well-being and development of preterm infants.
• Current pain control interventions require further evaluation for efficacy and additive effects.

Purpose of the Study:

• To compare the individual efficacy and combined effects of pain control interventions in preterm neonates.
• To evaluate Kangaroo Mother Care (KMC) and Music Therapy (MT) as pain relief methods.
• To establish optimal pain management strategies for heel-prick procedures in preterm infants.

Main Methods:

• A randomized controlled trial was conducted in a university-affiliated neonatal intensive care unit.
• 200 preterm neonates (26-36 weeks gestational age) undergoing heel-prick were assigned to four groups: KMC with MT, MT alone, KMC alone, or Control.
• Pain was assessed using the Premature Infant Pain Profile (PIPP) score via recorded videos. All groups received expressed breast milk as baseline intervention.

Main Results:

• Analysis of variance indicated a significant difference in total PIPP scores across the groups (P<0.001).
• Both KMC and KMC with MT groups showed significantly lower PIPP scores compared to the Control group (P<0.001 and P=0.001, respectively).
• No significant difference in PIPP scores was observed between the Control group and the Music Therapy alone group.

Conclusions:

• Kangaroo Mother Care, with or without Music Therapy, combined with expressed breast milk, effectively reduces pain during heel-prick in preterm neonates.
• Kangaroo Mother Care using expressed breast milk should be prioritized for pain control in preterm infants.
• The additive effect of music therapy to KMC warrants further investigation, though KMC alone demonstrates significant pain reduction.