Abstract/Details

Kangaroo care for analgesia in preterm infants undergoing heel stick pain


2006 2006

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Abstract (summary)

Heelstick is the most common painful procedure in hospitalized premature infants and may be associated with impaired physiological, neurologic and immunologic functioning. The purpose was to examine Kangaroo Care (KC) effect on heelstick pain as measured by the Premature Infant Pain Profile (PIPP) and heart rate variability (HRV) indices.

Twenty-eight preterm infants 30-32 weeks gestational age were tested in a crossover design. Fourteen were randomized to group A (incubator heelstick [IH] on day1; KC heelstick [KCH] on day2) and 14 to group B (KCH on day1; IH on day2). The first 18 were tested in an 80-minute protocol and the last 10 in a 30-minute protocol.

During the Heel Stick phase, in the 30-min protocol subgroup, PIPP scores were lower in KCH (range 4.00-10.60) than IH (range 9.75-14.33) and the difference between KCH and IH were >2 points (considered clinically important). Repeated-measures analysis showed that PIPP was lower in KCH than IH at 0.5 minute after the stick in the Total Sample, p < .05. Infants had an average of 27% less pain in KCH than IH and KC had a large effect on reducing pain.

During the Recovery phase, KCH infants had less pain at three time points (p < .05-.001) in the 30-minute protocol subgroup and at 2 time points (p < .05) in the Total Sample. Pain was 21%-25% less in KCH than IH, and KC had medium effect on reducing pain.

In KCH compared to IH, low frequency (LF, sympathetic activity) and high frequency power (HF, parasympathetic activity) were higher during Baseline (p < .05.01); LF was higher during Heel Stick (p < .001); and LF/HF ratio (balance of sympathetic-parasympathetic activity) was lower during Recovery (p < .001). Infants had better balanced autonomic activity in KCH than IH during their response to heelstick. Infants also had a shorter duration of bradycardia, higher SaO2, less decrement in SaO2 from Baseline to Heel Stick, and shorter or no oxygen desaturation in KCH than 1H. In conclusion, KC reduced bio-behavioral and autonomic pain responses in preterm infants undergoing heelstick pain during the first 2-9 days of life.

Indexing (details)


Subject
Nursing;
Pain management;
Foot diseases;
Premature birth;
Babies;
Analgesics
Classification
0569: Nursing
Identifier / keyword
Health and environmental sciences; Analgesia; Heel stick; Infants; Kangaroo care; Pain; Preterm
Title
Kangaroo care for analgesia in preterm infants undergoing heel stick pain
Author
Cong, Xiaomei
Number of pages
240
Publication year
2006
Degree date
2006
School code
0042
Source
DAI-B 66/11, Dissertation Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9780542407284, 0542407280
Advisor
Ludington-Hoe, Susan M.
University/institution
Case Western Reserve University
University location
United States -- Ohio
Degree
Ph.D.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
3196686
ProQuest document ID
305354544
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/305354544
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