Skin-to-Skin Contact and/or Oral 25% Dextrose for Procedural Pain Relief for Term Newborn Infants

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Chermont, Aurimery Gomes [UNIFESP]
Magno Falcao, Luis Fabio
Laurindo de Souza Silva, Eduardo Henrique
Xavier Balda, Rita de Cassia [UNIFESP]
Guinsburg, Ruth [UNIFESP]
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OBJECTIVE: the goal was to compare the efficacy of oral 25% dextrose treatment and/or skin-to-skin contact for analgesia in term newborns during intramuscular injection of a hepatitis B vaccine.METHODS: A prospective, randomized, partially blinded, clinical trial was performed with 640 healthy term newborns. Infants at 12 to 72 hours of life were assigned randomly to receive an intramuscular injection of hepatitis B vaccine in the right thigh according to 4 analgesia groups, that is, no analgesia (routine); oral 25% dextrose treatment, given 2 minutes before the injection; skin-to-skin contact, initiated 2 minutes before the injection and persisting throughout the procedure; and a combination of the oral dextrose treatment and skin-to-skin contact strategies. for all groups, Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were evaluated before the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection. Premature Infant Pain Pro. le scores also were assessed for all infants. Pain scores were compared among the 4 groups.RESULTS: the use of oral 25% dextrose treatment reduced the duration of procedural pain in the studied population. Skin-to-skin contact decreased injection pain and duration. the combination of the 2 analgesic measures was more effective than either measure separately for term newborns.CONCLUSIONS: Nonpharmacologic analgesic measures were effective for the treatment of procedural pain in term infants. the combination of oral 25% dextrose treatment and skin-to-skin contact acted synergistically to decrease acute pain in healthy neonates. Pediatrics 2009; 124: e1101-e1107
Pediatrics. Elk Grove Village: Amer Acad Pediatrics, v. 124, n. 6, p. E1101-E1107, 2009.