Comparison of the Effect of Yakson Touch and Oral Glucose on the Severity of Phlebotomy Pain in Preterm Infants

Document Type: Original Article

Authors

1 Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Neonatal Intensive Care, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Research Center of Prevention and Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Infants are exposed to different painful procedures during hospitalization in the neonatal intensive care unit (NICU). Due to the harmful effects of pain on infants, NICUs require methods by the aid of which the pain in infants can be controlled. Yakson touch and oral glucose are among non-pharmacological methods for pain relief in infants. In this regard, the present study was conducted to compare the effect of Yakson touch and oral glucose on the severity of phlebotomy pain in preterm infants.
Methods: In this randomized clinical trial, 99 preterm infants hospitalized in NICU were randomly allocated to three groups, including Yakson touch (n=33), oral glucose (n=33), and control (n=33). In the oral glucose group, 1 cc of 50% glucose was orally given to the infants 1 min before phlebotomy. In the Yakson touch group, touching was performed for 5 min, and then the phlebotomy was performed. The infants in the control group did not receive a specific treatment. Infant pain level was determined before and after the phlebotomy using video recording based on Neonatal Infant Pain Scale. The data were analyzed using the analytical statistical tests, including the analysis of variance, Chi-square, Wilcoxon, and Kruskal-Wallis, in SPSS software (version 20).
Results: The mean scores of pain in the two experimental groups were significantly lower than that of the control group (P=0.001), but there was no significant difference between the two experimental groups (P>0.05).
Conclusion: According to our findings, both two methods (i.e., Yakson touch and oral glucose) can reduce phlebotomy pain in preterm infants hospitalized in intensive care unit. It is recommended to use Yakson touch in case of lack of access to glucose.

Keywords


1. Salmani N, Karjoo Z, Dehghani K, Sadeghnia A. Effect of facilitated tucking created with simulated hands on physiological pain indicators during venipuncture in premature infants. Iran J Neonatol. 2017; 8(4): 7-12.
2. Obeidat H, Kahalaf I, Callister CL, Froelicher ES. Use of facilitated tucking for nonpharmacological pain management in preterm infants. J Perinat Neonatal Nurs. 2009; 23(4):372-7.
3. Axelin A, Salanterä S, Lehtonen L. ‘Facilitated tucking by parents’ in pain management of preterm infants-a randomized crossover trial. Early Hum Dev. 2006; 82(4):241-7.
4. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008; 300(1):60-70.
5. Sohrabimb MB, Aghayan SM, Zolfaghari P, Delmoradi F, Amerian F, Ghasemian Aghmashhadi 

M. Studying on signs of pain in neonates. Knowl Health. 2012; 6(3):50-3 (Persian).
6. Rihani T, Mohebbi T, Boskabadi H, Gholami H, Ghavami Ghanbarabadi V. The effect of facilitated tucking during venipuncture on pain and physiological parameters in preterm infants. Evid Based Care. 2012; 2(2):47-56 (Persian).
7. Sheikhbahaeddinzadeh E. Examination, diagnosis and nursing care in the NICU. Tehran: Boshra; 2012.
8. Hartley KA, Miller CS, Gephart SM. Facilitated tucking to reduce pain in neonates: evidence for best practice. Adv Neonatal Care. 2015; 15(3):201-8.
9. Nicholson JM, Berthelsen D, Abad V, Williams K, Bradley J. Impact of music therapy to promote positive parenting and child development. J Health Psychol. 2008; 13(2):226-38.
10. Saeedi R, Asnaashari Z, Amirinejad M, Esmaili H. The effect of Kangaroo care method on the pain intensity of vaccination in newborns. J Sabzevar Univ Med Sci. 2007; 13(4):172-8.
11. Tarhani F, Moumennasab M. A survey: glucose sedative effect in neonates during Venus blood sampling. Yafteh. 2004; 6(21):47-50 (Persian).
12. Nishitani S, Miyamura T, Tagawa M, Sumi M, Takase R, Doi H, et al. The calming effect of a maternal breast milk odor on the human newborn infant. Neurosci Res. 2009; 63(1):66-71.
13. Gibbins S, Stevens B, McGrath PJ. Comparison of pain-responses in infants of different gestational ages. Neonatology. 2008; 93(1):10-8.
14. Cloherty JP. Manual of neonatal care. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. P. 703-4.
15. Gibbins BS. Pain management; what is the right outcome? Newborn Infant Nurs Rev. 2007; 7(1):47-8.
16. Bueno M, Kimura AF, Diniz CS. Scientific evidences for managing pain in the neonatal population. Acta Paulista Enfermagem. 2009; 22(6):828-32.
17. Liaw JJ, Yang L, Katherine Wang KW, Chen CM, Chang YC, Yin T. Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomised controlled crossover trial. Int J Nurs Stud. 2012; 49(3):300-9.
18. Porter FL, Wolf CM, Gold J, Lotsoff D, Miller JP. Pain and pain management in newborn infants: a survey of physicians and nurses. Pediatrics. 1997; 100(4): 626-32.
19. Kucukoglu S, Kurt S, Aytekin A. The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns. Ital J Pediatr. 2015; 41(1):61.
20. Tsao JC, Evans S, Meldrum M, Altman T, Zeltzer LK. A review of CAM for procedural pain in infancy: part II. Other interventions. Evid Based Complement Alternat Med. 2008; 5(4):399-407.
21. Larsson BA, Tannfeldt G, Lagercrant H, Olsson GL. Venipuncture is more effective and less painful than heel lancing for blood tests in neonates. Pediatric.1998; 101(5):882-6.
22. Skogsdal Y, Eriksson M, Schollin J. Analgesia in newborn had given oral glucose. Acta Paediatr. 1997; 86(2):217-20.
23. Stevens B, Taddio A, Ohlsson A, Einarson T. The efficacy of sucrose for relieving procedural pain in neonat–a systematic review and meta-analysis. Acta Paediatr. 1997; 86(8):837-42.
24. Johnston C, Stremler R, Horton L, Friedman A. Effects of repeated doses of sucrose during heel stick procedures in preterm neonates. Biol Neonate. 1999; 75(3):160-6.
25. Blass E, Fitzgerald E, Kehoe P. Interactions between sucrose, pain and isolation distress. Pharamacol Biochem Behav. 1987; 26(3):483-9.
26. Barr RG, Que VS, Cousineau D, Oberlander TF, Brian JA, Young SN. Effects of intra-oral sucrose on crying, mouthing and hand-mouth contact in newborns and six-week-old infants. Dev Med Child Neurol. 1994; 36(7):608-18.
27. Meek J, Huertas A. Cochrane review: non-nutritive sucking, kangaroo care and swaddling/facilitated tucking are observed to reduce procedural pain in infants and young children. Evid Based Nurs. 2012; 15(3):84-5.
28. Stevens B, Yamada J, Lee GY, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2013; 1:CD001069.
29. Bahman Bijari B, Iranmanesh S, Eshghi F, Baneshi MR. Gentle human touch and Yakson: the effect on Preterm's behavioral reactions. ISRN Nurs. 2012; 2012:750363.
30. Im H, Kim E, Park E, Sung K, Oh W. Pain reduction of heel stick in neonates: Yakson compared to non-nutritive sucking. J Trop Pediatr. 2008; 54(1):31-5.
31. Eshghi F, Iranmanesh S, Bahman Bijari B, Borhani F, Motamed Jahromi M. Effects of Yakson therapeutic touch on the behavioral response of premature infants. J Babol Univ Med Sci. 2015; 17(10):15-21.
32. Park ES, Sung KS, Oh WO, Im HS, Kim ES, Kim YA, et al. Pain relieving effect of Yakson therapy for infants. Taehan Kanho Hakhoe Chi. 2006; 36(6): 897-904.
33. Parashar P, Samuel AJ, Bansal A, Aranka VP. Yakson touch as a part of early intervention in the Neonatal Intensive Care Unit: A systematic narrative review. Ind J Crit Care Med. 2016; 20(6):349-52.
34. Mitchell A, Waltman PA. Oral sucrose and pain relief for preterm infants. Pain Manag Nurs. 2003; 4(2):62-9.
35. Hatfield LA, Chang K, Bittle M, Deluca J, Polomano RC. The analgesic properties of intraoral sucrose: an integrative review. Adv Neonatal Care. 2011; 11(2):83-92.
36. Lawrence J, Alcock D, McGrath P, Kay J, MacMurray SB, Dulberg C. The development of a tool to assess neonatal pain. Neonatal Netw. 1993; 12(6):59-66.
37. Boroumandfar K, Khodaei F, Abdeyazdan Z, Maroufi M. Comparison of vaccination-related pain in infants who receive vapocoolant spray and breastfeeding during injection. Iran J Nurs Midwifery Res. 2013;

18(1):33.
38. Rafati S, Rejeh N, Tadrisi SD, Karimi M, Molodi A. Effect of massage on physiological pain responses of blood sampling in infant. Iran J Nurs Res. 2015; 10(2):45-53 (Persian).
39. Abbasi Z, Salari E, Rashidi F, Taherpour M. The effect of massage on the intensity of pain caused by vaccination in infants. J North Khorasan Univ Med Sci. 2011; 3(3):51-6 (Persian).
40. Herrington CJ, Chiodo LM. Human touch effectively and safely reduces pain in the newborn intensive care unit. Pain Manag Nurs. 2014; 15(1):107-15.
41. Im H, Kim E. Effect of Yakson and Gentle Human Touch versus usual care on urine stress hormones and behaviors in preterm infants: a quasi-experimental study. Int J Nurs Stud. 2009; 46(4): 450-8.
42. Harrison LL. The use of comforting touch and massage to reduce stress for preterm infants in the neonatal intensive care unit. Newborn Infant Nurs Rev. 2001; 1(4):235-41.
43. Eghbalian F, Shalchi Z. Comparing the efficacy of oral glucose 50%, acetaminophen and breast-feeding on reducing neonatal pain. J Urmia Univ Med Sci. 2014; 25(7):578-85 (Persian).
44. Khodam H, Sabzi Z. Effectiveness of oral sucrose on pain severity in term newborn undergoing heel prick. Iran J Nurs Res. 2011; 5(19):45-51 (Persian).
45. NooriShadkam M, Behjati M, Fallahzadeh H. Comparison of topical EMLA cream with oral glucose on pain reduction at venipuncture in Ichteric newborns. J Rafsanjan Univ Med Sci. 2005; 4(4):294-9 (Persian).