Does noninvasive electrical stimulation of acupuncture points reduce heelstick pain in neonates?
OBJECTIVE
Noninvasive electrical stimulation at acupuncture points (NESAP) for analgesia is used in children, but has not been widely studied in neonates. The purpose of this study was to determine whether NESAP alone or in combination with sucrose relieved heelstick pain in neonates.


METHODS
Term neonates (n = 162) receiving routine heelsticks for newborn screening were enrolled following parental consent. All infants received facilitated tucking and non-nutritive sucking. Neonates were randomised to standard care, sucrose, NESAP or sucrose plus NESAP. NESAP (3.5 mA, 10 Hz) or sham was administered over four acupuncture points. The Premature Infant Pain Profile (PIPP), heart rate variability (HRV) and salivary cortisol were used to measure heelstick pain.


RESULTS
PIPP scores among all four treatment groups increased during heelstick, F (9,119) = 1.95, p = 0.05 and NESAP therapy had no significant effect on PIPP scores. However, PIPP scores from baseline to heelstick increased the most in the two groups not receiving sucrose (p < 0.01). Mean PIPP scores remained below five during the heelstick in all four groups, indicating minimal or no pain. Differences in HRV and salivary cortisol among groups were insignificant.


CONCLUSIONS
NESAP at 3.5 mA, 10 Hz is not effective in relieving pain during heelsticks in neonates.
College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Anita J
AJ
Mitchell
Department of Pediatrics and Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Richard W
RW
Hall
Stanford University and Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.
Brenda
B
Golianu
Research Faculty at University of Arkansas for Medical Sciences, Department of Physical Therapy, University of Central Arkansas, Conway, AR, USA.
Charlotte
C
Yates
University of Arkansas for Medical Sciences, Little Rock, AR, USA.
David Keith
DK
Williams
University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Jason
J
Chang
Stanford University and Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.
Kanwaljeet J S
KJ
Anand
D001800:Blood Specimen Collection / Q000009:adverse effects*; D004311:Double-Blind Method; D015671:Electroacupuncture; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control*

NESAP
; 
PIPP
; Neonates; Pain; Sucrose