Breast Milk and Glucose for Pain Relief in Preterm Infants: A Noninferiority Randomized Controlled Trial

Bueno, Mariana; Stevens, Bonnie; Camargo, Patrícia Ponce de; Toma, Edi; Krebs, Vera Lúcia Jornada; Kimura, Amélia Fumiko

doi:10.1542/peds.2011-2024

Cited by 44 publications

(44 citation statements)

References 42 publications

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“…Compared with the IG, the CG participants exhibited a lower incidence of crying (CG: 42.2% vs. IG: 78.6%; p=0.001) and a shorter crying time after the heel puncture (CG: 14.53% vs. IG: 32.02%; p=0.014). The authors concluded that single doses and small volumes of milk are not effective for neonatal pain relief but that greater volumes might yield better results (11) . In contrast to that study, we did not use the participants' mothers' milk, in addition to using a different pain stimulus, which might have contributed to the divergence in the results.…”

Section: Discussionmentioning

confidence: 99%

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Human milk for neonatal pain relief during ophthalmoscopy

Ribeiro

Castral²,

Montanholi

et al. 2013

Rev. esc. enferm. USP

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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...

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Section: Discussionmentioning

confidence: 99%

“…Its use is further justified within the context of the strategies to stimulate breastfeeding, which are aimed at better motherand-child care (11) .…”

Section: Introductionmentioning

confidence: 99%

Human milk for neonatal pain relief during ophthalmoscopy

Ribeiro

Castral²,

Montanholi

et al. 2013

Rev. esc. enferm. USP

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“…Neonates in 25% dextrose group had statistically significant lower PIPP score and reduced cry time after venepuncture. Similarly, studies conducted by Sahoo et al (6) and Mariano et al (11) also showed that 25% dextrose decreased mean PIPP score and cry time after procedure compared to placebo . Costa et al aimed to evaluate the effect of 25% glucose during ophthalmic examination for retinopathy of prematurity in preterm infants using Neonate infant pain scale.…”

Section: Discussionmentioning

confidence: 70%

“…(8,9) Oral sweet solutions like sucrose and dextrose have been found to have pain relieving effects. (9,10) Trials using 25% dextrose (6,10,11,12) to reduce procedural pain in neonates have been done. Thus the following trial was done with the objective of determining the efficacy of oral 25% dextrose in comparison with placebo in reducing neonatal pain response after venepuncture with the help of PIPP pain scale.…”

Section: Introductionmentioning

confidence: 99%

Does Oral 25% Dextrose Effectively Reduce Procedural Pain in Neonates – A Randomized Controlled Trial

Abinaya¹

2017

jmscr

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“…Another measure performed by health professionals was winding, which can be used in many NBs as long as they are clinically monitored and stable, constituting a low cost and low risk measure (1) . Through gentle and regular stimulation, winding provides stimuli that can compete with stress and pain and must be performed prior to any procedure and maintained most of the time (4,33) . The facilitated containment, another strategy pointed out by health professionals and widely used in their practice, consists of the delicate control of extremities near the trunk, with lower and upper extremities flexed, and the hands close to the mouth.…”

Section: Discussionmentioning

confidence: 99%

Assistance flowchart for pain management in a Neonatal Intensive Care Unit

et al. 2018

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Objective: To describe and discuss the process of developing a fl owchart collectively constructed by the health team of a Neonatal Intensive Care Unit for the management of neonatal pain. Method: This is a descriptive and an exploratory study with a qualitative approach that used Problem-Based Learning as a theoretical-methodological framework in the process of developing the assistance fl owchart for the management of neonatal pain. Results: Based on this methodology, there was training in service and the discussion of key points of pain management by the health team, which served as input for the construction of the fl owchart. Final considerations: The assistance fl owchart for pain management, based on scientifi c evidence, provided means to facilitate the decision-making of the health team regarding the pain of the newborn. It is suggested to use the fl owchart frequently to promote the permanent education of the team and identify possible points to be adjusted. Descriptors: Pain Management; Neonatal Intensive Care Units; Workfl ow; Neonatal Nursing; Newborn. RESUMO Objetivo: Descrever e discutir o processo de desenvolvimento de um fl uxograma construído coletivamente pela equipe de saúde de uma Unidade de Terapia Intensiva Neonatal para o manejo da dor neonatal. Método: Trata-se de um estudo descritivo, exploratório, com abordagem qualitativa que usou a Aprendizagem Baseada em Problemas como referencial teórico-metodológico no processo de desenvolvimento do fl uxograma assistencial do manejo da dor neonatal. Resultados: A partir desta metodologia ocorreu uma capacitação em serviço e a discussão de pontos chaves do manejo da dor pela equipe de saúde, que serviram de subsídios para construção do fl uxograma. Considerações fi nais: O fl uxograma assistencial do manejo da dor, construído a partir de evidências científi cas, forneceu meios para facilitar a tomada de decisão da equipe de saúde frente à dor do recém-nascido. Sugere-se a aplicação do fl uxograma com frequência para promover a educação permanente da equipe e identifi car possíveis pontos a serem ajustados. Descritores: Manejo da Dor; Unidades de Terapia Intensiva Neonatal; Fluxo de Trabalho; Enfermagem Neonatal; Recém-Nascido. RESUMENObjetivo: Describir y discutir el proceso de desarrollo de un diagrama de fl ujo construido colectivamente por el equipo de salud de una Unidad de Terapia Intensiva Neonatal para el manejo del dolor neonatal. Método: Se trata de un estudio descriptivo, exploratorio, con un abordaje cualitativo que utilizó el Aprendizaje Basado en Problemas como referencial teórico-metodológico en el proceso de desarrollo del diagrama de fl ujo asistencial del manejo del dolor neonatal. Resultados: A partir de esta metodología ocurrió una capacitación en servicio y la discusión de puntos claves del manejo del dolor por el equipo de salud, los cuales sirvieron de subsidios para la construcción del diagrama de fl ujo. Consideraciones fi nales: El fl ujograma asistencial del manejo del dolor, construido a partir de evidencias cie...

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Breast Milk and Glucose for Pain Relief in Preterm Infants: A Noninferiority Randomized Controlled Trial

Abstract: Results based on PIPP scores and crying time indicate poorer effects of EBM compared with 25% glucose during heel lancing. Additional studies exploring the vol and administration of EBM and its combination with other strategies such as skin-to-skin contact and sucking are necessary.

Cited by 44 publications

References 42 publications

Human milk for neonatal pain relief during ophthalmoscopy

Human milk for neonatal pain relief during ophthalmoscopy

Does Oral 25% Dextrose Effectively Reduce Procedural Pain in Neonates – A Randomized Controlled Trial

Assistance flowchart for pain management in a Neonatal Intensive Care Unit

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