Neonatal Medicine

Randomized Controlled Trial: J Korean Soc Neonatol.. 2011;18(2):353-358. Published online November 25, 2011.
DOI: https://doi.org/10.5385/jksn.2011.18.2.353; Nonpharmacologic Pain Relief with Oral 25% Dextrose or/and Pacifier for Newborn Infants.; Min Kyung Kim, In Ah Kim, Min Hee Jung, Myung Ki Han, Kie Young Park, Bong Seong Kim, Hyun Seong Jin; ¹Department of Pediatrics, College of Medicine, Ulsan University, Seoul Asan Medical Center, Seoul, Korea.
²Department of Pediatrics, College of Medicine, Ulsan University, Gangneung Asan Medical Center, Gangneung, Korea. childlove72@naver.com

Abstract: PURPOSE
The goal of this study was to compare the efficacy of oral 25% dextrose treatment or/and pacifier for analgesia in healthy newborns during intramuscular injection of a hepatitis B vaccine.
METHODS
A prospective, randomized, partially blinded, clinical trial was performed in 132 healthy newborns. They were assigned randomly to 4 treatment groups: control group (2 mL distilled water), dextrose group (2 mL 25% dextrose), pacifier group, dextrose+ pacifier group (pacifier coating with 25% dextrose) during intramuscular injection of hepatitis B vaccine. For all groups, Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) scores were evaluated before the injection, during the injection, and at 2 minutes after the injection. Pain scores were compared among the 4 groups.
RESULTS
Maternal and neonatal characteristics were similar among the 4 groups. 25% dextrose treatment led to lower NIPS pain scores during injection (6.4+/-0.9 vs. 5.5+/-1.7, P=0.01) and after injection (1.6+/-2.0 vs. 0.6+/-0.9, P=0.01) and NFCS pain scores after injection (1.5+/-2.3 vs. 0.7+/-0.8, P=0.04) than control group. The number of neonates who feel the pain (indication of scores: NIPS> or =4, NFCS> or =3) decreased (9 (23.1%) vs. 0 (0%), P=0.04 via NIPS, 7 (17.9%) vs. 0 (0%), P=0.02 via NFCS). However, all treatment groups did not decreased PIPP scores, compared with the control group.
CONCLUSION
Oral 25% dextrose is effective than distilled water or using pacifier with or without 25% dextrose in reducing pain during intramuscular injection of hepatitis B vaccinations. Further study based on this preliminary study need about nonpharmacologic management of pain in newborns.

Keywords :Newborn;Infant;Pain;Pacifiers;Glucose