title: Physiological parameters after nonpharmacological analgesia in preterm infants: a randomized trial.
abstract: OBJECTIVE
  To compare the influence of three different nonpharmacological interventions on cortical activation, heart rate and peripheral oxygen saturation (SaO2 ) after heelstick in preterm infants.
  
  
  METHODS
  Twenty five preterm infants between 24 0/7 and 32 0/7 weeks of gestational age were randomized to either oral sucrose (S), facilitated tucking (FT) or a combination of the two interventions (SFT) prior to five heelsticks each within the first 14 days of life. SaO2 , heart rate and oxygenation of the somatosensory cortex, measured by near infrared spectroscopy (NIRS), were analysed.
  
  
  RESULTS
  Hundred and twenty five heelsticks were performed. The heart rate increased significantly after heelstick in all three intervention groups (p < 0.004 in all groups). The increase was higher in the FT group compared with the other groups (S: p = 0.007; SFT: p = 0.004). There was no difference among the two groups receiving sucrose (S and SFT; p = 0.87). SaO2 did not change significantly after heelstick in all intervention groups. Near infrared spectroscopy measurements did not show a significant change in the curve but patients in the FT group showed a trend towards higher average oxygenation of the contralateral somatosensory cortex.
  
  
  CONCLUSIONS
  Oral sucrose seems to be more effective in reducing reaction to pain than FT. Application of both interventions did not show an additive effect.
authors: Department of Pediatrics, Division of Neonatology, Inselspital and University of Berne, Berne, Switzerland. roland.gerull@insel.ch
authors: Roland
authors: R
authors: Gerull
authors: Eva
authors: E
authors: Cignacco
authors: Liliane
authors: L
authors: Stoffel
authors: Gila
authors: G
authors: Sellam
authors: Mathias
authors: M
authors: Nelle
mesh_terms: D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology*; D006365:Heel; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D010812:Physical Stimulation / Q000379:methods*; D011446:Prospective Studies; D011677:Punctures; D012372:ROC Curve; D012016:Reference Values; D013003:Somatosensory Cortex / Q000502:physiology; D019265:Spectroscopy, Near-Infrared; D013395:Sucrose / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013395:Sucrose