title: Effect of Vibration on Pain Response to Heel Lance: A Pilot Randomized Control Trial.
abstract: BACKGROUND
  Applied mechanical vibration in pediatric and adult populations has been shown to be an effective analgesic for acute and chronic pain, including needle pain. Studies among the neonatal population are lacking. According to the Gate Control Theory, it is expected that applied mechanical vibration will have a summative effect with standard nonpharmacologic pain control strategies, reducing behavioral and physiologic pain responses to heel lancing.
  
  
  OBJECTIVE
  To determine the safety and efficacy of mechanical vibration for relief of heel lance pain among neonates.
  
  
  METHODS
  In this parallel design randomized controlled trial, eligible enrolled term or term-corrected neonates (n = 56) in a level IV neonatal intensive care unit were randomized to receive either sucrose and swaddling or sucrose, swaddling, and vibration for heel lance analgesia. Vibration was applied using a handheld battery-powered vibrator (Norco MiniVibrator, Hz = 92) to the lateral aspect of the lower leg along the sural dermatome throughout the heel lance procedure. Neonatal Pain, Agitation, and Sedation Scale (N-PASS) scores, heart rate, and oxygen saturations were collected at defined intervals surrounding heel lancing.
  
  
  RESULTS
  Infants in the vibration group (n = 30) had significantly lower N-PASS scores and more stable heart rates during heel stick (P = .006, P = .037) and 2 minutes after heel lance (P = .002, P = .016) than those in the nonvibration group. There were no adverse behavioral or physiologic responses to applied vibration in the sample.
  
  
  CONCLUSIONS
  Applied mechanical vibration is a safe and effective method for managing heel lance pain. This pilot study suggests that mechanical vibration warrants further exploration as a nonpharmacologic pain management tool among the neonatal population.
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, Georgia (Ms McGinnis, Dr McCracken, and Mr Travers); and Children's Healthcare of Atlanta, Georgia (Mss McGinnis, Murray, and Cherven and Mr Travers).
authors.forename: Kate
authors.initials: K
authors.lastname: McGinnis
authors.forename: Eileen
authors.initials: E
authors.lastname: Murray
authors.forename: Brooke
authors.initials: B
authors.lastname: Cherven
authors.forename: Courtney
authors.initials: C
authors.lastname: McCracken
authors.forename: Curtis
authors.initials: C
authors.lastname: Travers
mesh_terms: D001800:Blood Specimen Collection; D006339:Heart Rate; D006365:Heel; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010092:Oximetry; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010865:Pilot Projects; D011677:Punctures / Q000009:adverse effects* / Q000379:methods; D013395:Sucrose / Q000627:therapeutic use; D013549:Sweetening Agents / Q000627:therapeutic use; D014732:Vibration / Q000627:therapeutic use*
chemical_list: D013549:Sweetening Agents; D013395:Sucrose