25 May 2012

Swaddling eases pain in preemies

Swaddling premature babies appears to ease the pain of medical procedures in intensive care, new research shows.


Swaddling premature babies appears to ease the pain of medical procedures in intensive care, new research shows.

The finding confirms those of past studies and was presented at the American Pain Society's annual meeting in Honolulu, Hawaii.

Reducing procedural pain is "a noble and appropriate goal, especially in neonates where pain assessment may be difficult," said Dr Randall Clark, who heads the Paediatric Anaesthesiology section at the University Of Colorado School Of Medicine.

"Nurses and physicians should make themselves aware of the literature on non-pharmacologic pain relief and should seriously consider employing these methods in clinical practice, when possible," Dr Clark said. He was not involved in the new research.

How the study was done

In the new study, researchers at the Chinese University of Hong Kong randomly assigned 54 premature newborns either to facilitated swaddling, or to a control group that had no intervention.
During a heel stick blood draw, they evaluated pain responses at intervals before, during and minutes after the procedure.

To rate the patients' pain, the researchers examined seven indicators on the Premature Infant Pain Profile. Those included heart rate, oxygen saturation, three facial responses, behaviour and gestational age.

The swaddled infants gave significantly less signs of pain compared to the control group during the procedure, immediately afterward, and two, four and six minutes afterward.

The mean heart rate and oxygen saturation were significantly lower at every measured time period. And the swaddled patients recovered their baseline heart-rate and oxygen levels at two minutes after the procedure, compared to the control group, which recovered a baseline heart rate at an average of six minutes afterward, and oxygen saturation at eight minutes.

Swaddling highly recommended

The two researchers who conducted the study did not observe any adverse effects.

Citing a 1965 paper by Melzack et al in Science, Dr Simone Ho, one of the two researchers, suggested to Reuters Health that swaddling may affect pain through stimulation of the proprioceptive, thermal and tactile sensory systems.

Dr Ho echoes Dr Clark's suggestion that this intervention should become standard care.

"Swaddling as a pain relief intervention for heel stick procedures among pre-term neonates is highly recommended in the clinical setting since this non-pharmacological intervention is simple, safe, low cost, and evidence-based," Dr Ho said.

(Rob Goodier, Reuters Health, May 2012) 

Read more:

Premature babies struggle in life

Pain in children




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