title: The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain.
abstract: BACKGROUND
  Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous system.
  
  
  OBJECTIVE
  The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain.
  
  
  METHODS
  Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group.
  
  
  RESULTS
  Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005).
  
  
  CONCLUSIONS
  The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns.
authors.affiliation: Faculty of Health Science, Ataturk University, Department of Child Health and Disease Nursing, Erzurum, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Kucukoglu
authors.affiliation: Faculty of Health Science, Ataturk University, Department of Child Health and Disease Nursing, Erzurum, Turkey.
authors.forename: Ayda
authors.initials: A
authors.lastname: Celebioglu
authors.affiliation: Faculty of Medicine, Ataturk University, Department of Child Health and Diseases, Erzurum, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Caner
authors.affiliation: Ataturk University, Yakutiye Investigation Hospital, Newborn Clinic.
authors.forename: Gamze
authors.initials: G
authors.lastname: Ok
authors.affiliation: Ataturk University, Yakutiye Investigation Hospital, Newborn Clinic.
authors.forename: Rukiye
authors.initials: R
authors.lastname: Maden
keywords: EMLA cream; Nursing; Pain; Premature; Vaccination