title: The effect of facilitated tucking during endotracheal suctioning on procedural pain in preterm neonates: a randomized controlled crossover study.
abstract: BACKGROUND
  Premature infants not only feel and understand the pain, but also respond more intensively compared with term infants. Non-pharmacological methods of pain control are suitable to relieve pain in painful procedures. The facilitated tucking position is considered as a non-pharmacological method of pain control in infants; however, its impact on frequent and repeated procedural pain such as endotracheal suctioning remains to be studied.
  
  
  OBJECTIVE
  This paper is the report of a study that examined the impact of facilitated tucking position on behavioral pain during suctioning in premature neonates.
  
  
  METHODS
  This was a clinical trial study with a crossover design.
  
  
  METHODS
  The study was conducted in a level II Neonatal Intensive Care Unit, located in a teaching hospital, affiliated to Tehran University of Medical Sciences, Tehran, Iran.
  
  
  METHODS
  Thirty four infants were enrolled in this study based on the following inclusion criteria: age between 29 to 37 weeks of gestational age, birth weight 1200 grams or more, having an endotracheal tube, no congenital anomalies, no seizures diagnosis, no chest tubes, no intracranial hemorrhage higher than degree II, not receiving opiates and sedatives four hours before intervention and not receiving any painful procedure at least half an hour before the intervention.
  
  
  METHODS
  The samples were randomly received a sequence of suctioning with/without or suctioning without/with facilitated tucking. Preterm Infant Pain Profile (PIPP) was used to collect the data. SPSS version 16.0 for Windows (SPSS Inc., Chicago, IL, USA) was used for statistical analysis.
  
  
  RESULTS
  While 38.2% of infants experienced severe pain during suctioning without intervention, only 8.8% of them experienced severe pain during suctioning with intervention. The results of the paired t-test show that there is a statistically significant difference in the mean scores of pain between non-intervention and intervention cases (p < 0.001), and the mean pain score substantially reduced in cases with intervention.
  
  
  CONCLUSIONS
  Given the multiplicity of endotracheal suctioning frequency and the impossibility of frequent use of pharmacological methods of pain relief, the facilitated tucking position can be used as a safe non-pharmacological method for procedural pain management.
authors.forename: Mona
authors.initials: M
authors.lastname: Alinejad-Naeini
authors.affiliation: Assistant Professor, Department of Pediatrics, Division of Neonatology, Newborn Intensive Care Unit (NICU), Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. pmahagh@yahoo.com.
authors.forename: Parisa
authors.initials: P
authors.lastname: Mohagheghi
authors.forename: Hamid
authors.initials: H
authors.lastname: Peyrovi
authors.forename: Abbas
authors.initials: A
authors.lastname: Mehran
mesh_terms: D018592:Cross-Over Studies; D060867:Facilitated Tucking / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000379:methods*; D007492:Iran; D008297:Male; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods; D013396:Suction / Q000379:methods*