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A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
Study protocol: parents as pain management in Swedish neonatal care - SWEpap, a multi-center randomized controlled
Emma Olsson1,2, Martina Carlsen Misic3,4, Randi Dovland Andersen5,6
1Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden. emma.olsson@oru.se.
Insights
Parents can effectively manage newborn pain during procedures using skin-to-skin contact, breastfeeding, and lullabies. This study investigates these combined, parent-driven strategies for infant pain relief.
Area of Science:
- Neonatal care
- Pain management
- Pediatrics
Background:
- Newborn infants, both healthy and critically ill, endure frequent painful procedures.
- Parents are a crucial, yet often underutilized, resource in managing infant procedural pain.
- Enhanced parental knowledge and involvement are essential for effective infant pain management.
Purpose of the Study:
- To evaluate the efficacy of combined, parent-driven non-pharmacological pain management strategies in newborns.
- To compare the effectiveness of skin-to-skin contact, breastfeeding, and lullaby singing against standard care during infant metabolic screening.
Main Methods:
- A multi-center randomized controlled trial (RCT) with three parallel groups (1:1:1 allocation).
- The study, "Parents as pain management in Swedish neonatal care - SWEpap," focuses on routine metabolic screening (PKU-test).
- Interventions include combined skin-to-skin contact, breastfeeding, and live parental lullaby singing.
Main Results:
- Few studies have examined the efficacy of combined multisensorial, parent-driven interventions.
- Existing research suggests combined parent-driven methods (e.g., skin-to-skin, breastfeeding) are more effective than single interventions.
- Parental soothing behaviors providing rhythmic or orogustatory/orotactile stimulation are effective in painful contexts.
Conclusions:
- Parental involvement offers valuable pain-alleviating strategies for newborns.
- Live parental lullaby singing is an unexplored, promising adjuvant to established methods like skin-to-skin contact and breastfeeding.
- Further research is needed on combined multisensorial parent-driven pain management in neonatal care.
Background:
During the first period of life, critically ill as well as healthy newborn infants experience recurrent painful procedures. Parents are a valuable but often overlooked resource in procedural pain management in newborns. Interventions to improve parents' knowledge and involvement in infants' pain management are essential to implement in the care of the newborn infant. Neonatal pain research has studied a range of non-pharmacological pain alleviating strategies during painful procedures, yet, regarding combined multisensorial parent-driven non-pharmacological pain management, research is still lacking.
Methods/Design:
A multi-center randomized controlled trial (RCT) with three parallel groups with the allocation ratio 1:1:1 is planned. The RCT "Parents as pain management in Swedish neonatal care - SWEpap", will investigate the efficacy of combined pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test).
Discussion:
Parental involvement in neonatal pain management enables a range of comforting parental interventions such as skin-to-skin contact, breastfeeding, rocking and soothing vocalizations. To date, few studies have been published examining the efficacy of combined multisensorial parent-driven interventions. So far, research shows that the use of combined parent-driven pain management such as skin-to-skin contact and breastfeeding, is more effective in reducing behavioral responses to pain in infants, than using the pain-relieving interventions alone. Combined parental soothing behaviors that provide rhythmic (holding/rocking/vocalizing) or orogustatory/orotactile (feeding/pacifying) stimulation that keep the parent close to the infant, are more effective in a painful context. In the SWEpap study we also include parental live lullaby singing, which is an unexplored but promising biopsychosocial, multimodal and multisensory pain alleviating adjuvant, especially in combination with skin-to-skin contact and breastfeeding.
Trial Registration:
ClinicalTrials.gov ( NCT04341194 ) 10 April 2020.
