Akbari Negarin, Mutlu Birsen, Khoddam Homeira
Faculty of Health Sciences, Department of Nursing, Fenerbahce University, Istanbul, Turkey.
Florence Nightingale Faculty of Nursing, Pediatric Nursing Department, İstanbul University-Cerrahpaşa, Istanbul, Turkey.
Breastfeed Med. 2025 Apr;20(4):244-255. doi: 10.1089/bfm.2024.0123. Epub 2024 Dec 10.
Preterm infants in the neonatal intensive care unit (NICU) frequently undergo painful procedures, which can lead to both short-term and long-term complications, including potential mortality. Effective pain management is crucial in this context. Although numerous studies have explored non-pharmacological pain relief methods for preterm infants, no research has simultaneously compared the effects of maternal breast milk odor, facilitated tucking, and nonnutritive sucking. This study aims to comparatively investigate the efficacy of nonnutritive sucking, facilitated tucking, and maternal breast milk odor in reducing pain in preterm neonates during heel sticks. A randomized controlled trial was conducted in a tertiary-level NICU with 144 preterm neonates (gestational age 31-36 weeks) requiring heel sticks. The infants were randomly assigned to four groups: control, nonnutritive sucking, facilitated tucking, and maternal breast milk odor. Pain and physiological parameters were assessed through video recordings of the procedures and scored at 1-minute intervals using the Premature Infant Pain Profile and Data Evaluation Form. Data were collected at baseline and at 1, 2, and 3 minutes before, during, and after the heel stick. The study found significant effects of the interventions on physiological parameters and pain (heart rate: = 7.5, < 0.001; oxygen saturation: = 16.39, < 0.001; respiratory rate: = 6.56, < 0.001; pain: = 61.45, < 0.001). Facilitated tucking resulted in significantly lower pain scores (6.61 ± 1.44) compared with the control group (14.22 ± 3.61), maternal breast milk odor (12.22 ± 3.08), and nonnutritive sucking (10.41 ± 1.71) ( < 0.001). All interventions demonstrated effectiveness in maintaining physiological stability and alleviating pain. Nevertheless, the intervention identified as most effective in reducing pain was facilitated tucking group.
新生儿重症监护病房（NICU）中的早产儿经常要接受痛苦的操作，这可能会导致短期和长期并发症，包括潜在的死亡风险。在这种情况下，有效的疼痛管理至关重要。尽管许多研究已经探索了针对早产儿的非药物性疼痛缓解方法，但尚无研究同时比较母乳气味、舒适包裹和非营养性吸吮的效果。本研究旨在比较非营养性吸吮、舒适包裹和母乳气味在足跟采血期间减轻早产儿疼痛方面的效果。在一家三级NICU对144名需要进行足跟采血的早产儿（胎龄31 - 36周）进行了一项随机对照试验。婴儿被随机分为四组：对照组、非营养性吸吮组、舒适包裹组和母乳气味组。通过操作的视频记录评估疼痛和生理参数，并使用早产儿疼痛量表和数据评估表每隔1分钟进行评分。在足跟采血前、采血期间和采血后的基线以及第1、2和3分钟收集数据。研究发现这些干预措施对生理参数和疼痛有显著影响（心率：F = 7.5，P < 0.001；血氧饱和度：F = 16.39，P < 0.001；呼吸频率：F = 6.56，P < 0.001；疼痛：F = 61.45，P < 0.001）。与对照组（14.22 ± 3.61）、母乳气味组（12.22 ± 3.08）和非营养性吸吮组（10.41 ± 1.71）相比，舒适包裹组的疼痛评分显著更低（6.61 ± 1.44）（P < 0.001）。所有干预措施在维持生理稳定性和减轻疼痛方面均显示出有效性。然而，被确定为在减轻疼痛方面最有效的干预措施是舒适包裹组。
