Human milk for neonatal pain relief during ophthalmoscopy

Abstract

RESUMOO exame de fundo de olho para o diagnós-tico precoce da retinopatia da prematuridade causa dor no prematuro, sendo necessárias intervenções que a minimizem. O objetivo foi investigar a efetividade do leite humano para alívio da dor em prematuros submetidos ao exame de fundo de olho para diagnóstico precoce da doença, em comparação com a sacarose. Tratou-se de um estudo piloto de caráter quase experimental, realizado com 14 prematuros internados na unidade neonatal de um hospital universitário. Na comparação entre os grupos, não houve diferença estatística significativa relacionada à duração do tempo de choro, concentração do cortisol salivar e frequência cardíaca. O leite humano parece ser tão efetivo quanto a sacarose no alívio da dor aguda relacionada ao exame. Tem-se como limitação o tamanhoreduzido da amostra e a falta de randomização. É necessária a realização de estudos experimentais com maior poder amostral para fortalecer as evidências encontradas. DESCRITORES ABSTRACTOphthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP) is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU) of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR). Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study's limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study. DESCRIPTORSPain Infant, premature Milk, human Retinopathy of prematurity Maternal-child nursing RESUMENEl examen de fondo de ojo para el diagnós-tico precoz de retinopatía prematura causa dolor en el prematuro, siendo necesarias intervenciones que la minimicen. El objetivo fue investigar la efectividad de la leche humana para el alivio del dolor en los prematuros sometidos al examen de fondo de ojo para el diagnóstico precoz de la enfermedad, en comparación con la sacarosa. Estudio piloto de carácter cuasi-experimental, realizado con 14 prematuros internados en la unidad neonatal de un hospital universitario. En la comparación entre los grupos, no hubo diferencia estadística significativa relacionada a la duración del tiempo del llanto, la concentración del cortisol salival y la frecuencia cardiaca. La leche humana parece ser tan efectiva como la sacarosa en el alivio del dolor agudo debido al examen. Una limitación fue el reducido tamaño de la muestra y la falta de aleatorización. Es necesaria la realización de estudios experimentales con mayor tamaño de...

Efficacy of Single Dose Oral Paracetamol in Reducing Pain During Examination for Retinopathy of Prematurity: A Blinded Randomized Controlled Trial

“…A total of 9 (7.8 %) infants experienced episodes of desaturations and bradycardia without a significant difference between the groups. Oral paracetamol group had a significantly lower PIPP score during examination of the first eye, following insertion of the speculum [12 (9)(10)(11)(12)(13) vs. 14 (13-15), p 0.01] ( Table 2; Fig. 2).…”

“…Similarly, Costa et al suggested that oral glucose solution is effective for pain relief during ROP examination [12]. In an another study, Riberio et al stated that human milk as well as oral sucrose are effective for relieving pain in this procedure [11].…”

“…Despite topical anesthetics and/or oral administration of non-pharmacological solutions such as oral sucrose, oral glucose or maternal milk before eye examination, most infants score highly on validated pain scores, such as the Premature Infant Pain Profile (PIPP) [11][12][13][14].…”

(Un)receptiveness in interactions with professionals: experiences of parents of children with retinopathy of prematurity

“…Literature provides different strategies for pain relief in neonatology, including 25.0% sucrose and breast milk, both indicated and with a positive effect on pain reduction caused by the eye fundus examination (22) . Another aspect appreciated in this and in another study (23) was the importance of transforming linguistic barriers, mainly related to technical jargon as they constitute limits to dialogue and to intersubjectivity (20) .…”

“…The care space cannot be restricted to technical acts; it must be broadened in order to allow subjects to develop connection, concern and consideration for each other. It requires active and empathic listening from the health professional that, if present, attributes quality to the care (22) . In this sense, professional health training needs to be actively involved in such a challenge (21) .…”