An experimental study on the use of manual pressure to reduce pain in neonates during heel prick

Pao Yue-kong Library Electronic Theses Database

An experimental study on the use of manual pressure to reduce pain in neonates during heel prick

 

Author: Yu, Chit
Title: An experimental study on the use of manual pressure to reduce pain in neonates during heel prick
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Infants (Newborn) -- Care.
Blood -- Collection and preservation.
Analgesia.
Pain.
Department: School of Nursing
Pages: x, 98 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2318152
URI: http://theses.lib.polyu.edu.hk/handle/200/4820
Abstract: AIM: Manual pressure over the needle stick site could inhibit the transmission of pain by 'closing the gate' to decrease nociceptive transmission of pain associated with heel stick. The aim of this study is to determine the effects of gentle manual pressure applied to needle stick site immediately prior to heel stick on pain responses assessed by the Neonatal Infant Pain Scale (NIPS) (primary outcome), heart rate, respiratory rate and oxygen saturation (secondary outcomes) in infants who required a heel stick. METHODS: This randomized, open labeled, crossover trial with healthy, term neonates 3-8 days old excluded those with diseases other than physiological jaundice; has congenital abnormalities, bodily measurements (body weight, length and head circumference) not within normal range according to growth chart; consumed analgesic/sedative within 48 h in significant quality or quantity; or used sucrose or breast-milk shortly before heel prick. After informed consent, 9 infants received 10 sec of gentle manual pressure over the needle stick site immediately prior to heel stick on the first study sampling and no manual pressure on the next sampling. 8 infants had the reverse order. The researcher measured NIPS during the heel prick. Heart rate, respiratory rate, and oxygen saturation was measured prior to massage and 1 min after heel stick. RESULTS: In 17 infants, there were no adverse physiologic effects of manual pressure. During heel prick, the NIPS were significantly lower (p=0.01) under the manual pressure condition compared with the no manual pressure condition. Heart rate, respiratory rate, and oxygen saturation were in general not significantly different between the two conditions. CONCLUSION: Gentle manual pressure over the needle stick site prior to heel stick is safe and decreases pain responses in preterm infants.

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