Iranian Journal of Neonatology

Iranian Journal of Neonatology

Effect of Tuina Massage on Pain during Orogastric Tube Insertion in Premature Neonates: A Randomized Controlled Trial

Document Type : Original Article

Authors
Sara Faramarzi 1
Nahid Naseri 2
Ayoub Panahi 1
Arash Malakian 3
Faraz Tayyar Iravanlou 4
1 Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Department of Pediatric Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 School of Medicine, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4 Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
10.22038/ijn.2025.84200.2621
Abstract
Background: Orogastric tube insertion is a painful procedure for neonates, particularly premature infants who are more vulnerable to pain and its consequences. Non-pharmacological, safe, and cost-effective pain management methods are essential in neonatal care. Tuina, a traditional Chinese massage technique, may reduce procedural pain in this population. This study aimed to evaluate the effect of Tuina massage on pain during orogastric tube insertion in premature neonates.
Methods: A randomized controlled trial was conducted on 70 premature neonates admitted to a maternal and neonatal hospital in Ahvaz, Iran. Participants were randomly assigned into intervention (Tuina massage) and control (routine care) groups (n=35 each) using block randomization with R software. Pain levels, heart rate, and oxygen saturation were assessed using the Premature Infant Pain Profile (PIPP) at three time points: five minutes before, during, and five minutes after tube insertion. The intervention group received Tuina massage three times, each lasting one minute with 30-second intervals during these phases.
Results: The intervention group showed a significant reduction in pain scores during and after tube insertion compared to the control group (p = 0.001, Cohen’s d = 0.927). Heart rate decreased and oxygen saturation increased significantly post-intervention in the Tuina group (p = 0.029).
Conclusion: Tuina massage is an effective, accessible, and low-cost method for reducing procedural pain and improving physiological parameters in premature neonates, supporting its use as a valuable non-pharmacological intervention in NICU settings.
 
Keywords
Neonatal pain
Non-pharmacological intervention
Orogastric tube
Premature infant pain profile
Premature neonates
Tuina massage
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Iranian Journal of Neonatology
Volume 17, Issue 1
Winter 2026
Pages 20-26