Effect of Heat Application during Intramuscular Injection of Vitamin K in Pain Prevention in Neonates

Document Type : Original Article

Authors

1 Non-Communicable Pediatric Diseases Research Center, Department of Pediatrics, Babol University of Medical Sciences, Babol, Iran

2 Department of Pediatrics, Babol University of Medical Sciences, Amirkola Children’s Hospital, Babol, Iran

Abstract

Background: Several modalities have been proposed to reduce procedural pain in neonates. This study was conducted to determine whether heat of a non-human source might help with pain management in infants.
Methods: In this clinical trial, 40 full-term healthy neonates in their first hours of life were randomly divided into two groups of intervention and control. The control group was put under a radiant warmer using the servo-controlled method for four minutes and the temperature was set to 35.5°C. The intervention group was put under the servocontrolled mode with the temperature of 35.5°C for two minutes, then two minutes in manual mode with 100% power. Vitamin K injection was performed. The severity of pain in infants was measured by an independent observer by means of Neonatal Infant Pain Scale (NIPS) before the injection, 20 seconds during the injection, as well as 60 and 120 seconds after the injection. The difference in pain score was compared between the two groups using Chi-squared test, repeated measures analysis of variance, and independent t-test.
Results: The two groups were similar in terms of gestational age, birth weight, Apgar score, and maternal age. The mean of NIPS scores was 2.9 in intervention group and 4 in the control group during injection, which was significantly different (P=0.001). No significant difference was recorded in skin temperature and pain scores before and after injection.

Keywords

References

1. Urso AM. The reality of neonatal pain and the resulting effects. J Neonat Nurs. 2007; 13(6):236-8.
2. Unruh AM, Strong J, Van Griensven H. Introduction to pain. In: van Griensven H, Strong J, Unruh AM, editors. Pain: a textbook for therapists. Edinburgh: Churchil Livingstone; 2013. P. 100.
3. Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000; 284(4):428-9.
4. Gallo A. The fifth vital sign: implementation of the Neonatal Infant Pain Scale. J Obstet Gynecol Neonatal Nurs. 2002; 32(2):199-206.
5. Pillai Riddell RR, Horton RE, Hillgrove J, Craig KD. Understanding caregivers’ Judgments of infant pain: contrasts of parents, nurses and pediatricians. Pain Res Manag. 2008; 6(13):489-96.
6. Anand KJ. Pharmacological approaches to the management of pain in the neonatal intensive care unit. J Perinatol. 2007; 27(Suppl 1):S4-11.
7. Batton DG, Barrington KJ, Wallman C. Prevention and management of pain in the neonate: an update. Pediatrics. 2006; 118(5):2231-41.
8. 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.
9. Simons SH, Van Dijk M, Anand KS, Roofthooft D, Van Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med. 2003; 157(11):1058–64.
10. Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2004; 3:CD001069.
11. Çheraghi F, Shamsaee F. Study on signs of pain in neonates admitted in pediatric wards of the hospitals affiliated to Hamedan University of medical sciences. J Mazandaran Univ Med Sci. 2002; 12(37):55-63 (Persian).
12. Axelin A. Parents as pain killers in the pain management of preterm infants. Early Hum Dev. 2006; 82:241-7.
13. Waldan M, Carrier C. The ten commandments of pain assessment and management in preterm neonates. Crit Care Nurs Clin North Am. 2009; 21(2):235-52.
14. Anand K. Assessment of neonatal pain. PaediatrPerinat Drug Ther. 2004; 6(2):97-103.
15. Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012; 27(6):652-81.
16. Skarbek-Borowska S, Becker BM, Lovgren K, Bates A, Minugh PA. Brief focal ultrasound with topical anesthetic decreases the pain of intravenous placement in children. Pediatr Emerg Care. 2006; 22(5):339-45.
17. Asadi Noghabi F, Kashaninia Z, Sajedi F, Rahgozar M, Yousefi H. The effect of skin-to-skin contact on the pain intensity of intramuscular. Horizon Med Sci. 2011; 16(4):5-11 (Persian).
18. Lewis M, Ramsay D. Soothing and stress. Mahwah, England: Lawrence Erlbaum Associates; 1999.
19. Rao M, Blass EM, Brignol MM, Marino L, Glass L. Reduced heat loss following sucrose ingestion in premature and normal human newborns. Early Hum Dev. 1997; 48(1-2):109-16.
20. Walden M. Pain assessment and management. In: Verclan MT, Walden M. Core curriculum neonatal intensive care nursing. 4th ed. New York: Saunders Elsevier; 2010. P. 333-53.
21. Clifford PA, Stringer M, Christensen H, Mountain D. Pain assessment and intervention for term newborns. J Midwifery Womens Health. 2004; 49(6):514-9.
22. Gray L, Lang CW, Porges SW. Warmth is analgesic in healthy newborns. Pain. 2012; 153(5):960–6.
23. Dilen B, Elseviers M. Oral glucose solution as pain relief in newborns: results of a clinical trial. Birth. 2010; 37(2):98-105.
24. Ahmadpour-Kacho M, Zahedpasha Y, Hajian K, Ghaemi HR. Effect of oral glucose on pain prevention in neonates. Arch Dis Childhood. 2008; 93(Suppl 2):pw239.
25. Golianu B, Krane E, Seybold J, Almgren C, Anand KJ. Non-pharmacological techniques for pain management in neonates. Semin Perinatol. 2007; 31(5):318-22.
 

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