Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants.
OBJECTIVE
The goal was to compare the efficacy of oral 25% dextrose treatment and/or skin-to-skin contact for analgesia in term newborns during intramuscular injection of a hepatitis B vaccine.


METHODS
A prospective, randomized, partially blinded, clinical trial was performed with 640 healthy term newborns. Infants at 12 to 72 hours of life were assigned randomly to receive an intramuscular injection of hepatitis B vaccine in the right thigh according to 4 analgesia groups, that is, no analgesia (routine); oral 25% dextrose treatment, given 2 minutes before the injection; skin-to-skin contact, initiated 2 minutes before the injection and persisting throughout the procedure; and a combination of the oral dextrose treatment and skin-to-skin contact strategies. For all groups, Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were evaluated before the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection. Premature Infant Pain Profile scores also were assessed for all infants. Pain scores were compared among the 4 groups.


RESULTS
The use of oral 25% dextrose treatment reduced the duration of procedural pain in the studied population. Skin-to-skin contact decreased injection pain and duration. The combination of the 2 analgesic measures was more effective than either measure separately for term newborns.


CONCLUSIONS
Nonpharmacologic analgesic measures were effective for the treatment of procedural pain in term infants. The combination of oral 25% dextrose treatment and skin-to-skin contact acted synergistically to decrease acute pain in healthy neonates.
Chermont
Aurimery Gomes
AG
Department of Pediatrics, Federal University of Pará, Belém, Brazil.
Falcão
Luis Fábio Magno
LF
de Souza Silva
Eduardo Henrique Laurindo
EH
de Cássia Xavier Balda
Rita
R
Guinsburg
Ruth
R
D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D001938:Brazil; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D059408:Pain Management; D010147:Pain Measurement; D011292:Premedication; D011446:Prospective Studies; D014110:Touch; D016896:Treatment Outcome
D017325:Hepatitis B Vaccines; D005947:Glucose