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The effect of combined non-pharmacological interventions on venous blood sampling pain in preterm infants: a clinical
Fatemeh Yadollahzadeh1, Zahra Akbarianrad2, Seyedeh Roghayeh Jafarian-Amiri3
1Student Research Committee, Fatemeh Yadollahzadeh (MSc), Babol University of Medical Sciences, Babol, Iran.
Insights
Combined non-pharmacological interventions, including sucrose, non-nutritive sucking, and swaddling, significantly reduced pain in preterm infants during venous blood sampling. The combination of all three interventions proved most effective in managing procedural pain.
Area of Science:
- Neonatal care
- Pediatric pain management
- Evidence-based practice
Background:
- Effective pain management in hospitalized infants is crucial for preventing adverse physical and psychological outcomes.
- Non-pharmacological methods are a priority for newborn health, especially during painful procedures.
Purpose of the Study:
- To investigate the efficacy of combined non-pharmacological interventions in alleviating pain associated with venous blood sampling in preterm infants.
Main Methods:
- A randomized clinical trial involving 88 preterm infants in a Neonatal Intensive Care Unit.
- Infants were assigned to four groups: sucrose (S), sucrose with non-nutritive sucking (NS), sucrose with swaddling (SS), and sucrose with non-nutritive sucking and swaddling (NSS).
- Pain was assessed using the Premature Infant Pain Profile Scale (PIPP).
Main Results:
- The combined intervention of sucrose, non-nutritive sucking, and swaddling (NSS) demonstrated significantly greater pain reduction compared to sucrose alone (mean difference 4.68, P < 0.001).
- Significant pain reduction was observed in the NS group compared to the S group (mean difference 3.54, P < 0.001).
- Pain scores differed significantly across all groups before-during and during-after blood sampling (P < 0.001).
Conclusions:
- Combined non-pharmacological interventions, particularly the combination of non-nutritive sucking and swaddling with sucrose, are highly effective in reducing pain during venous blood sampling in preterm infants.
- The NSS intervention was more effective than using one or two non-pharmacological methods.
- These findings support the integration of multimodal non-pharmacological strategies in neonatal pain management.
Background:
Using non-pharmacological methods to reduce the pain of hospitalized infants is one of the most important priorities in the health of newborns. Pain relief during painful procedures can help prevent unwanted physical and psychological effects. This study was conducted with the aim of investigating the effect of combined non-pharmacological interventions on venous blood sampling pain in preterm infants.
Methods:
In this clinical trial study, 88 preterm infants admitted to the Neonatal Intensive Care Unit of Rouhani Hospital was randomly assigned to four groups of sucrose (S), the combined group of sucrose and non-nutritive sucking (NS), the combined group of swaddle and sucrose (SS) and the combined group of sucrose, non-nutritive sucking and swaddling (NSS). In order to collect information, were used the premature Infant Pain Profile Scale (PIPP) and demographic characteristics questionnaire.
Results:
This study showed that during blood sampling, the difference in the mean pain score of two groups of S and NS was equal to 3.54 (95% CI = 1.85, 5.24) and in two groups S and NSS was equal to 4.68 (95% CI = 2.99, 6.38), and these differences were significant (P < 0.001). In addition, the mean pain difference in all study groups was significant in two time periods before-during and during-after blood sampling (P < 0.001). Also, the mean pain difference in the two time periods before-during and during-after in NS and NSS groups was significant compared to the control group (sucrose) (P < 0.001).
Conclusions:
Based on the results of this study, the use of combined non-pharmacological interventions of NSS has been more effective in reducing the pain caused by venous blood sampling than other conditions where two or one non-pharmacological intervention were used.
