Volume 63(1); January

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Clin Exp Pediatr > Volume 63(1); 2020
Neonatology (Perinatology)
Clinical and Experimental Pediatrics 2020;63(1):25-29.
DOI: https://doi.org/10.3345/kjp.2017.05841    Published online August 16, 2019.
Effectiveness of various nonpharmacological analgesic methods in newborns
Pancham Kumar1  , Rakesh Sharma1, Sukhdev Rathour1, Sunidhi Karol2, Mohit Karol1
1Department of Pediatrics, Indira Gandhi Medical College, Shimla, India
2Department of Community Medicine, PT. B. D. Sharma PGIMS, Rohtak, India
Correspondence: 
Pancham Kumar,Email: panchamdr@gmail.com
Received: 5 August 2017   • Revised: 27 July 2019   • Accepted: 13 August 2019
Abstract
Background
Pain during the developmental period may adversely affect developing neuronal pathways and result in adverse neurodevelopmental, cognitive, and behavioral effects in later life. Immunizations, e.g., hepatitis B vaccine (HBV), administered at birth are painful experiences to which neonates are universally subjected.
Purpose
Here we aimed to study and compare the effectiveness of various nonpharmacological pain management methods in newborns to enable the development of safe and effective analgesic methods for newborns.
Methods
This prospective study was conducted at a tertiary care hospital in the Himalayan region. Three hundred term healthy neonates were divided into 6 groups of 50 each. Groups 1–5 were intervention groups, patients of which received a nonpharmacological intervention (breastfeeding, nonnutritive sucking, rocking, 25% sucrose, or distilled water) before the intramuscular HBV, while patients in group 6 received no intervention. The pain response in each group after the HBV injection was assessed and compared using cry duration and Douleur Aigue Nveau-ne (DAN) score, a behavioral acute pain rating scale for newborns.
Results
Cry duration was decreased in all intervention groups, significantly so in the sucrose (19.90 seconds), breastfeeding (31.57 seconds), and nonnutritive sucking (36.93 seconds) groups compared with controls (52.86 seconds). DAN scores decreased significantly (P<0.05) at one or more points i.e. 30, 60, or 120 seconds in the breastfeeding and 25% sucrose intervention groups compared with controls.
Conclusion
Oral sucrose and nonnutritive sucking are simple yet underutilized nonpharmacological interventions that effectively reduce pain in newborns.
Key Words: Nonpharmacological methods, Analgesia, Newborn infant, Hepatitis B vaccines




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