title: Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial.
abstract: Many attempts have been made to obtain safe and effective analgesia in newborns. Oral glucose-water has been found to have analgesic properties in neonates. We investigated whether other sensory stimulation added to oral glucose provided more effective analgesia than oral glucose alone. In a randomized prospective double-blind trial, we studied 120 term newborns during heel prick. The babies were divided randomly into six groups of 20, and each group was treated with a different procedure during heel prick: A) control; B) 1 mL 33% oral glucose given 2 min before the heel prick; C) sucking; D) 1 mL 33% oral glucose plus sucking; E) multisensory stimulation including 1 mL 33% oral glucose (sensorial saturation); F) multisensory stimulation without oral glucose. Sensorial saturation consisted in massage, voice, eye contact, and perfume smelling during heel prick. Each heel prick was filmed and assigned a point score according to the Douleur Aiguë du Nouveau-né (DAN) neonatal acute pain scale. Camera recording began 30 s before the heel prick, so it was impossible for the scorers to distinguish procedure A (control) from B (glucose given 2 min before), C (sucking water) from D (sucking glucose), and E (multisensory stimulation and glucose) from F (multisensory stimulation and water) from the video. Procedure E (multisensory stimulation and glucose) was found to be the most effective procedure, and the analgesia was even more effective than that produced by procedure D (sucking glucose). We conclude that sensorial saturation is an effective analgesic technique that potentiates the analgesic effect of oral sugar. It can be used for minor painful procedures on newborns.
authors.affiliation: Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Italy.
authors.forename: Carlo Valerio
authors.initials: CV
authors.lastname: Bellieni
authors.forename: Franco
authors.initials: F
authors.lastname: Bagnoli
authors.forename: Serafina
authors.initials: S
authors.lastname: Perrone
authors.forename: Anna
authors.initials: A
authors.lastname: Nenci
authors.forename: Duccio Maria
authors.initials: DM
authors.lastname: Cordelli
authors.forename: Mara
authors.initials: M
authors.lastname: Fusi
authors.forename: Simona
authors.initials: S
authors.lastname: Ceccarelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
mesh_terms: D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D018730:Infant Behavior; D007231:Infant, Newborn; D008297:Male; D010147:Pain Measurement; D010812:Physical Stimulation; D013268:Stimulation, Chemical
chemical_list: D005947:Glucose