Howard Caoimhe, Powell Anna S, Pavlidis Elena, Pavel Andreea, Finn Daragh, Allen Andrew, Olavarria-Ramirez Loreto, Clarke Gerard, Livingstone Vicki, Boylan Geraldine B, Dempsey Eugene M
Department of Paediatrics and Child Health, Neonatal Intensive Care Unit, Cork University Maternity Hospital, Cork, Ireland.
INFANT, Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.
Acta Paediatr. 2020 Mar;109(3):511-517. doi: 10.1111/apa.15018. Epub 2019 Oct 18.
To investigate the effect of a musical intervention on neonatal stress response to venepuncture as measured by salivary cortisol levels and pain profile scores.
In a randomised control crossover trial, participants were randomised to both a control arm (sucrose) and intervention arm (sucrose and music) for routine venepuncture procedures. Salivary swabs were collected at baseline, 20 minutes post-venepuncture and 4 hours post-venepuncture. Pain levels were assessed using the Premature Infant Pain Profile (PIPP). A total of 16 preterm neonates participated in both arms to complete the study.
Cortisol values were elevated at all timepoints in the intervention arm (baseline, 20 minutes, and 4 hours post-procedure) but not significantly so (P = .056, P = .3, and P = .575, respectively). Median change in cortisol values from baseline was +128.48 pg/mL (-47.66 to 517.02) at 20 minutes and +393.52 pg/mL (47.88-1221.34) at 4 hours post-procedure in the control arm compared to -69.564 pg/mL (-860.96 to 397.289) and +100.48 pg/mL (-560.46 to 842.99) at 20 minutes and 4 hours post-procedure in the intervention arm. There was no statistically significant difference observed between groups (P = .311 at 20 minutes, and P = .203 at 4 hours post-procedure). PIPP scores were not significantly different between study arms.
Our findings did not support the additional benefit of music intervention on neonatal stress response to venepuncture in preterm infants.
通过唾液皮质醇水平和疼痛特征评分来研究音乐干预对新生儿静脉穿刺应激反应的影响。
在一项随机对照交叉试验中,参与者被随机分为对照组(蔗糖)和干预组(蔗糖和音乐),接受常规静脉穿刺程序。在基线、静脉穿刺后20分钟和静脉穿刺后4小时采集唾液拭子。使用早产儿疼痛特征量表(PIPP)评估疼痛程度。共有16名早产儿参与了两组实验以完成该研究。
干预组在所有时间点(基线、20分钟和术后4小时)的皮质醇值均升高,但差异无统计学意义(分别为P = 0.056、P = 0.3和P = 0.575)。与干预组术后20分钟和4小时分别为-69.564 pg/mL(-860.96至397.289)和+100.48 pg/mL(-560.46至842.99)相比,对照组术后20分钟皮质醇值从基线的中位数变化为+128.48 pg/mL(-47.66至517.02),术后4小时为+393.52 pg/mL(47.88 - 1221.34)。两组之间未观察到统计学上的显著差异(术后20分钟P = 0.311,术后4小时P = 0.203)。研究组之间的PIPP评分无显著差异。
我们的研究结果不支持音乐干预对早产儿静脉穿刺新生儿应激反应有额外益处。