The Comparison of Pain Caused by Suprapubic Aspiration and Transurethral Catheterization Methods for Sterile Urine Collection in Neonates: A Randomized Controlled Study

Abstract

This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants' faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P = 0.1). The mean (SD) of the PIPP pain scores did not differ between groups (9.95 ± 3.7 in SPA and 9.64 ± 3.2 in TUC, P = 0.6). The duration of TUC was longer. Both methods can be used to collect urine from neonates, but the difficulty of performing TUC on females and uncircumcised males should be considered.

Analgesia, nil or placebo to babies, in trials that test new analgesic treatments for procedural pain

“…Our search generated 45 studies and in 31 of these the source of pain was a routine heel prick or venepuncture. The other pain sources were two studies involving eye examinations; three involving endotracheal or nasal suctioning; three involving oro/nasogastric tube placement; and one each involving circumcision, intubation, transurethral catheterisation, hepatitis B vaccine injection, adhesive tape removal, arterial puncture and central vein catheterisation.…”

Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children

“…Resource availability and clinician experience may limit their utilisation in some settings. Use of invasive methods is also strongly influenced by clinical factors, discomfort caused to the child and parental preferences 9 27 28. Usual care will vary according to these factors, though in some settings urethral catherisation or suprapubic aspiration is already the dominant practice 20.…”

“…We did not include parental costs such as travel and time off work, although these would likely strengthen conclusions given parental costs likely reflect time taken. Quality of life was not included, but children’s pain and parents’ distress are important considerations 28 29…”

Validation of the Persian Version of Premature Infant Pain Profile-Revised in Hospitalized Infants at the Neonatal Intensive Care Units

“…PIPP was used for clinical research in Iran (23,24), but a literature review in Medline and Google Scholar revealed the revised PIPP has not been used or validated in Iran.…”