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Peripherally Inserted Central Catheter (PICC) Maintenance Affects Pain and Comfort in Preterm Infants: Effectiveness

Türkan Kadiroğlu1, İlknur Budancamanak, Ebru Betül Albayrak

  • 1Author Affiliations: Department of Pediatric Nursing, Ataturk University, Erzurum, Turkey (Dr Kadiroğlu, Ms Budancamanak, Ms Albayrak) and Department of Neonatology, Ataturk University, Erzurum, Turkey (Ms Budancamanak, Ms Albayrak, Prof Tekgündüz, Prof Kara).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|September 29, 2025
PubMed

Insights

Palmar Grasp Reflex (PGR) stimulation significantly reduced pain and crying time in preterm infants undergoing Peripherally Inserted Central Catheter (PICC) maintenance. This nonpharmacological method improved infant comfort during the procedure.

Area of Science:

  • Neonatal care
  • Pediatric nursing
  • Pain management

Background:

  • Peripherally Inserted Central Catheter (PICC) maintenance can cause pain and distress in preterm infants.
  • Effective pain management strategies are crucial for neonatal intensive care unit (NICU) patients.

Purpose of the Study:

  • To assess pain and comfort levels in preterm infants during PICC maintenance.
  • To evaluate the impact of Palmar Grasp Reflex (PGR) stimulation on pain and comfort during PICC maintenance.

Main Methods:

  • A crossover randomized controlled trial was conducted with preterm infants (<37 weeks gestational age) undergoing their first PICC maintenance.
  • Palmar Grasp Reflex (PGR) stimulation was applied during the experimental condition.
  • Pain and comfort were measured using the Preterm Infant Pain Profile-Revision (PIPP-R) and COMFORTneo scales via video analysis.

Main Results:

  • PGR stimulation resulted in statistically significant improvements in PIPP-R and COMFORTneo scores compared to the control condition.
  • The effect of PGR stimulation on reducing infant crying duration was strong and significant (R² = .519).

Conclusions:

  • PGR stimulation is an effective nonpharmacological intervention to reduce pain and enhance comfort in preterm infants during PICC maintenance.
  • Nurses can utilize PGR stimulation as a therapeutic touch during painful neonatal procedures.
  • Further research into other nonpharmacological methods for pain reduction during PICC maintenance is recommended.
Abstract

Keywords:
catheterizationcryinginfantintensive care unitsneonatalpain managementperipheralpremature

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