Skin‐to‐skin contact during eye examination did not reduce pain compared to standard care with parental support in preterm infants

Abstract

Aim: We compared the pain relieving effect of skin-to-skin contact versus standard care in the incubator during screening for retinopathy of prematurity.Methods: This randomised crossover study included 35 preterm infants of less than 32 weeks of gestational age admitted to St Olavs University Hospital, Trondheim, Norway, between January 2014 and June 2016. Randomisation was for skin-to-skin with one of the parents or standard care with supportive positioning by parents for the first of two consecutive eye examinations. The pain score was measured twice using the Premature Infant Pain Profile (PIPP) during and after the eye examination. The infants' movement activity was video recorded after the examination.Results: There was no difference in mean pain scores with skin-to-skin contact versus standard care during (10.2 vs. 10.3, p = 0.91) or after (7.0 vs. 6.8, p = 0.76) the procedure. Independent of the randomisation group, PIPP scores were lower than previous comparable studies have found. Bouts of movement activity were also the same whether the examination was conducted in skin-to-skin position or in the incubator (p = 0.91).Conclusion: Skin-to-skin contact during the eye examination did not provide additional pain relief compared to standard care where the parents were already a part of the multidimensional approach.

State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

“…Almost half of the included studies, 44 papers, reported on SSC with parents for neonatal pain relief, but only one included fathers in the intervention (66). The papers were published from 2000 to 2020, with nine from the USA, eight from India, seven from Iran, six from Canada, and the rest from various places around the world.…”

Avoiding use of lid speculum and indentation reduced infantile stress during retinopathy of prematurity examinations

“…However, these authors assigned the PIPP score separately for each phase of fundoscopy, that is, speculum insertion, indirect ophthalmoscopy and scleral indentation during indirect ophthalmoscopy, and reported the average for the entire examination, so these results are not comparable to ours (Cogen et al 2011). In another study by Kristoffersen et al, two methods of pain relief were compared during ROP examinations (Kristoffersen et al 2019). Premature Infant Pain Profile (PIPP) score during eye examination (digital imaging) with skin-to-skin contact versus standard care with parental support in the intubator was found to be 10.2 versus 10.3, respectively; however, again, these figures are not directly comparable to ours for a number of reasons.…”

“…In another study by Kristoffersen et al., two methods of pain relief were compared during ROP examinations (Kristoffersen et al. 2019). Premature Infant Pain Profile (PIPP) score during eye examination (digital imaging) with skin‐to‐skin contact versus standard care with parental support in the intubator was found to be 10.2 versus 10.3, respectively; however, again, these figures are not directly comparable to ours for a number of reasons.…”

Systematic Review of the Effectiveness of Involving Parents During Painful Interventions for Their Preterm Infants

“…Overall, 11 of the 22 included studies were parallel-group RCTs (Akcan et al, 2009;Castral et al, 2008;de Sousa Freire et al, 2008;Dezhdar et al, 2016;Gao et al, 2015;Holsti et al, 2011;Kostandy et al, 2008;Olsson et al, 2016;Sen & Manav, 2020;; V. V. , and 11 were randomized crossover trials (Axelin et al, 2006(Axelin et al, , 2009Cong et al, 2009Cong et al, , 2011Cong et al, , 2012Johnston et al, 2003Johnston et al, , 2008Johnston et al, , 2009Kristoffersen et al, 2019;Ludington-Hoe et al, 2005;Nimbalkar et al, 2013). Five studies were conducted in the United States (Cong et al, 2009(Cong et al, , 2011(Cong et al, , 2012Kostandy et al, 2008;Ludington-Hoe et al, 2005), six were conducted in Europe (Akcan et al, 2009;Axelin et al, 2006Axelin et al, , 2009Kristoffersen et al, 2019;Olsson et al, 2016;Sen & Manav, 2020), four were conducted in Canada (Holsti et al, 2011;Johnston et al, 2003Johnston et al, , 2008Johnston et al, , 2009, two were conducted in Brazil (Castral et al, 2008;de Sousa Freire et al, 2008), three were conducted in India (Nimbalkar e...…”