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Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial.
Pain. 2019 11; 160(11):2580-2588.PAIN

Abstract

Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during a single procedure; however, evidence of sustained efficacy over repeated procedures is limited. We aimed to determine the relative sustained efficacy of maternal KC, administered alone or in combination with 24% sucrose, to reduce behavioral pain intensity associated with routine neonatal procedures, compared with 24% sucrose alone. Stable preterm infants (n = 242) were randomized to receive KC and water, KC and 24% sucrose, or 24% sucrose before all routine painful procedures throughout their neonatal intensive care unit stay. Pain intensity, determined using the Premature Infant Pain Profile, was measured during 3 medically indicated heel lances distributed across hospitalization. Maternal and neonatal baseline characteristics, Premature Infant Pain Profile scores at 30, 60, or 90 seconds after heel lance, the distribution of infants with pain scores suggesting mild, moderate, or severe pain, Neurobehavioral Assessment of the Preterm Infant scores, and incidence of adverse outcomes were not statistically significantly different between groups. Maternal KC, as a pain-relieving intervention, remained efficacious over time and repeated painful procedures without evidence of any harm or neurological impact. It seemed to be equally effective as 24% oral sucrose, and the combination of maternal KC and sucrose did not seem to provide additional benefit, challenging the existing recommendation of using sucrose as the primary standard of care.

Authors+Show Affiliations

Department of Pediatrics, Psychology and Neuroscience, School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada. Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada.Ingram School of Nursing, McGill University, Montreal, QC, Canada.Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada. School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada. School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada.Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada. Department of Pediatrics, Dalhousie University, Halifax, NS, Canada.Neuroscience Research Division, Douglas Institute, McGill University, Montreal, QC, Canada.Centre for Pediatric Pain Research, Isaac Walton Killam Health Centre, Halifax, NS, Canada. School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Department of Psychiatry, University of Toronto, Toronto, ON, Canada.Neonatal Intensive Care Unit, IWK Health Centre Halifax, NS, Canada.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31356452

Citation

Campbell-Yeo, Marsha, et al. "Sustained Efficacy of Kangaroo Care for Repeated Painful Procedures Over Neonatal Intensive Care Unit Hospitalization: a Single-blind Randomized Controlled Trial." Pain, vol. 160, no. 11, 2019, pp. 2580-2588.
Campbell-Yeo M, Johnston CC, Benoit B, et al. Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial. Pain. 2019;160(11):2580-2588.
Campbell-Yeo, M., Johnston, C. C., Benoit, B., Disher, T., Caddell, K., Vincer, M., Walker, C. D., Latimer, M., Streiner, D. L., & Inglis, D. (2019). Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial. Pain, 160(11), 2580-2588. https://doi.org/10.1097/j.pain.0000000000001646
Campbell-Yeo M, et al. Sustained Efficacy of Kangaroo Care for Repeated Painful Procedures Over Neonatal Intensive Care Unit Hospitalization: a Single-blind Randomized Controlled Trial. Pain. 2019;160(11):2580-2588. PubMed PMID: 31356452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial. AU - Campbell-Yeo,Marsha, AU - Johnston,C Celeste, AU - Benoit,Britney, AU - Disher,Timothy, AU - Caddell,Kim, AU - Vincer,Michael, AU - Walker,Claire-Dominique, AU - Latimer,Margot, AU - Streiner,David L, AU - Inglis,Darlene, PY - 2019/7/30/pubmed PY - 2019/7/30/medline PY - 2019/7/30/entrez SP - 2580 EP - 2588 JF - Pain JO - Pain VL - 160 IS - 11 N2 - Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during a single procedure; however, evidence of sustained efficacy over repeated procedures is limited. We aimed to determine the relative sustained efficacy of maternal KC, administered alone or in combination with 24% sucrose, to reduce behavioral pain intensity associated with routine neonatal procedures, compared with 24% sucrose alone. Stable preterm infants (n = 242) were randomized to receive KC and water, KC and 24% sucrose, or 24% sucrose before all routine painful procedures throughout their neonatal intensive care unit stay. Pain intensity, determined using the Premature Infant Pain Profile, was measured during 3 medically indicated heel lances distributed across hospitalization. Maternal and neonatal baseline characteristics, Premature Infant Pain Profile scores at 30, 60, or 90 seconds after heel lance, the distribution of infants with pain scores suggesting mild, moderate, or severe pain, Neurobehavioral Assessment of the Preterm Infant scores, and incidence of adverse outcomes were not statistically significantly different between groups. Maternal KC, as a pain-relieving intervention, remained efficacious over time and repeated painful procedures without evidence of any harm or neurological impact. It seemed to be equally effective as 24% oral sucrose, and the combination of maternal KC and sucrose did not seem to provide additional benefit, challenging the existing recommendation of using sucrose as the primary standard of care. SN - 1872-6623 UR - https://www.unboundmedicine.com/medline/citation/31356452/Sustained_efficacy_of_kangaroo_care_for_repeated_painful_procedures_over_neonatal_intensive_care_unit_hospitalization:_a_single_blind_randomized_controlled_trial_ L2 - https://doi.org/10.1097/j.pain.0000000000001646 DB - PRIME DP - Unbound Medicine ER -