title: A feasibility and efficacy randomised controlled trial of swaddling for controlling procedural pain in preterm infants.
abstract: OBJECTIVE
  This study aimed to investigate the feasibility and efficacy of swaddling to control procedural pain among preterm infants.
  
  
  BACKGROUND
  Swaddling has been recommended for controlling neonatal pain. However, the feasibility for use is uncertain and insufficient evidence is available among preterm infants.
  
  
  METHODS
  A two-arm randomised controlled trial with repeated measures.
  
  
  METHODS
  The study was conducted in a 21-bed neonatal intensive care unit of a regional hospital in Hong Kong. Preterm infants who required heelstick procedure were eligible. Fifty-four preterm infants between 30-37 gestational weeks were randomly assigned to swaddling (n = 27) and control (standard care, n = 27) groups. Pain assessment was performed pre, during, immediate, two, four, six and eight minutes after heelstick procedure using the Premature Infant Pain Profile.
  
  
  RESULTS
  The mean Premature Infant Pain Profile scores were significantly reduced in the intervention group compared to the control group during, immediate, two, four, and six minutes after the heelstick procedure. The mean changes of heart rate and oxygen saturation in the intervention group were significantly lower than that of the control group at all measured time points. Notably, the swaddled infants quickly resumed to the baseline level at two minutes whereas the control group reached the stable state at an extended period of six minutes.
  
  
  CONCLUSIONS
  The findings show that swaddling is feasible and efficacious in controlling pain for heelstick procedure among preterm infants. No adverse effects were observed.
  
  
  CONCLUSIONS
  This article presents the feasibility and efficacy of swaddling as a non-pharmacological and non-invasive intervention to relieve pain during the heelstick procedures among preterm infants. Swaddling can contribute to control minor procedural pain in neonates as one of the simple, safe, cost effective, humanistic and natural analgesia alternatives.
authors.affiliation: Neonatal Unit, Prince of Wales Hospital, Hong Kong SAR, China.
authors.forename: Lai Ping
authors.initials: LP
authors.lastname: Ho
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
authors.forename: Simone S M
authors.initials: SS
authors.lastname: Ho
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Doris Y P
authors.initials: DY
authors.lastname: Leung
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Winnie K W
authors.initials: WK
authors.lastname: So
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Carmen W H
authors.initials: CW
authors.lastname: Chan
mesh_terms: D001512:Bedding and Linens; D001800:Blood Specimen Collection / Q000451:nursing*; D005260:Female; D006723:Hong Kong; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010147:Pain Measurement; D016896:Treatment Outcome
keywords: heelstick; intervention; neonatal care; pain; preterm; swaddling