4.2 Article

Effect of kangaroo mother care on pain during orogastric tube insertion in low-birthweight newborns: An open label, randomised trial

Journal

JOURNAL OF PAEDIATRICS AND CHILD HEALTH
Volume 58, Issue 12, Pages 2248-2253

Publisher

WILEY
DOI: 10.1111/jpc.16212

Keywords

feeding tube; kangaroo mother care; neonatal pain; orogastric tube

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This study aimed to investigate the pain-reducing effect of kangaroo mother care (KMC) during orogastric tube insertion in newborns. The results showed that KMC significantly reduced pain scores during and after the procedure, and this effect lasted for at least 15 minutes after the procedure.
Aim: Non-pharmacological methods are commonly used to reduce the procedural pain in newborns. In this open label, randomised control trial, we studied the pain-reducing effect of kangaroo mother care (KMC) during orogastric tube insertion. Methods: Newborns, with birthweight 1500-2499 g and admitted to nursery, were randomised into control (no-KMC) or intervention (KMC) arms. In intervention arm, KMC was given for 60 min before and after the procedure. Premature Infant Pain Profile-Revised (PIPP-R) score was used to assess the pain response and the pain severity was graded as minimal or no pain (<6), mild-to-moderate (7-12) and severe (>12). The PIPP-R scoring was done before, during and at 3- and 15-min after procedure. Change in PIPP-R scores from baseline was calculated. Results: Newborns included in no-KMC (n = 40) or KMC (n = 40) arms were comparable for major confounders (P > 0.05). Pre-procedural pain scores were comparable (P = 0.72). Pain scores measured during and after procedure were significantly higher in no-KMC group than KMC arm. The KMC reduced the pain score by 39%, 32% and 30% during and at 3- and 15-min after procedure respectively as compared to control (P < 0.01). The increase in PIPP-R score from pre-procedural level was 40%, 35% and 31% lower in KMC than no-KMC arm (P < 0.01). A greater proportion of newborns had significantly less severe grades of pain in the intervention arm compared to the no-KMC arm (P < 0.01). Conclusion: Orogastric tube placement is a painful procedure. KMC significantly reduces periprocedural pain and its effect continues for at least 15 min after the procedure.

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