Non-pharmacological measures for pain relief in venipuncture in newborns: description of behavioral and physiological responses

Abstract

BACKGROUND AND OBJECTIVES:Venipuncture is considered a painful procedure, often performed in the neonatal intensive care unit. The objective of this study is to describe the behavioral and physiological responses of newborns undergoing venipuncture, with and without the use of non-pharmacological measures for the relief of pain. METHODS: A total of 84 newborns participated in this research. It was observed if the nurse prepared the newborn for the puncture. Newborns that did not receive the non-pharmacological approach were allocated in group 1, and those who received were to group 2. The behavioral and physiological parameters were assessed two minutes before and two minutes after the procedure in all newborns. The data analysis was descriptive. RESULTS: Before the procedure, 45.5% of the newborns in group 1 had a contracted face; however, after the procedure, this number increased to 69.7%. After the procedure in group 2, 29.4% grumbled, 3.9% had a vigorous cry, 66.7% did not cry. Arms and legs movement had similar responses in both groups. After the procedure, 72.7% of newborns in group 1 had a heart rate higher than 160bpm. After the procedure in group 1, 15.2% had an oxygen saturation between 96 and 100% and this value increase to 58.8% in group 2. Non-pharmacological measures for pain relief in venipuncture in newborns: description of behavioral and physiological responsesMedidas não farmacológicas para alívio da dor na punção venosa em recém-nascidos: descrição das respostas comportamentais e fisiológicas

Nursing Care in Peripheral Intravenous Catheterization in Hospitalized Children: Integrative Review

“…No articles classified as level I (systematic review or metaanalysis of multiple randomized controlled clinical studies) or level III (almost experimental studies -without randomization) were found. Most articles were level VI (descriptive or qualitative research) 63% [1][2]5,[16][17][18][19][20][21][22][23][24] ; followed by 21% of level IV articles (case-control and cohort studies) [25][26][27][28] , and levels II (individual studies with controlled and randomized experimental design) 4 , V (systematic reviews of descriptive (non-experimental) or qualitative studies) 29 and VII (expert opinions) 30 with 5% each 9 . Continuing the analyses of each article, Chart 1 was prepared for better visualization of participants and objectives related to the CIP.…”

“…The experience with PIC can be painful, stressful and frustrating for patients. It is important to include pain relief measures as standard practice 16,18,25,27,32 . J-Tip is a pharmacological technology for pain control caused by venous puncture, used by professionals specialized in PIC in pediatrics, it includes the application of pressure lidocaine without a subcutaneous needle, which provides local anesthesia within two to three minutes 26 .…”

“…Another relevant point for nursing concerns the pain caused by the PIC process 16,27,32 . The neonatal population presents behavioral and physiological responses such as contracted face, grumbling, contracted arms and legs, shorthand and hypo saturation when submitted to PIC without the use of pain relief measures.…”

Effect of music combined with swaddling on pain in full-term newborns: randomized clinical trial

“…Based on these strategies, non-pharmacological measures are forms of care that should be performed in neonatal units (5) , such as comfort, touch, kangaroo care, tucking, nurturance, holding the baby (6) , swaddling (6)(7) , and music (7) .…”

Prevalence and Therapeutic Approach of Acute Pain in Emergency Provided by Triage Nursing

“…Se resalta la importancia del automanejo y autocontrol del paciente, siempre que no se caiga en la autoprescripción indiscriminada. Algunas de las técnicas no farmacológicas empleadas en el tratamiento del dolor son la presión/masaje, vibración, calor y frío superficiales, aplicación de criolíquidos como el mentol, la estimulación nerviosa eléctrica transcutánea, y a estas se pueden añadir otras como la distracción y la relajación(12)(13).Según datos de la Sociedad Española del Dolor y del Banco Mundial (organismo dependiente de las Naciones Unidas), existen 182 unidades del dolor(14), lo que para España representa, con sus 45.840.050 de habitantes a 2018, una unidad especial de tratamiento del dolor por cada 251.868 habitantes(15). En comparación con países vecinos de la Unión Europea, y como bien lo señala el Ministère de la Santé et de la Protection Sociale, en toda la región francesa, incluyendo Reunión, Martinica, Guadalupe, Guayana, Córcega y Mayotte, se dispone de un total de 266 unidades o centros de tratamiento del dolor, es decir, de una unidad por cada 248.898 habitantes(16).Cada hospital dispone en España de su unidad de dolor dependiente del Ministerio de Sanidad Política Social e Igualdad, según fuentes del ministerio(17).…”