Supervisors info:
Σουλτάνα Σιαχανίδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπουσα
Μαρία-Ροζέ Πονς-Ροντρίγκεθ, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Μίχος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
BACKGROUND: The effective pain management is the desirable standard of care for preterm newborns, as it may improve their clinical and neurodevelopmental outcomes. Although, neonatal pain is manageable with a variety of interventions including oral solu-tions with sweet taste, there is no consensus on the treatment strategy regarding prema-ture neonates. Despite the use of breastmilk as analgesic before painful procedures has been studied adequately in term neonates and infants, the data are sparse in premature neonates.
AIM: The purpose of this trial was to investigate whether breastmilk as a prophylactic in-tervention, has a better analgesic effect compared with dextrose solution 10% in prema-ture neonates who are subject to heel lancing.
METHODOLOGY: Α prospective clinical trial was carried out in NICU of “IASO” Maternity Hospital. Clinically steady premature neonates, who were on oral feedings, were included. Each neonate, in the context of routine investigations during their NICU stay, underwent heel lancing, twice at different time points. Previously, 0,2-0,5 ml/kg of breastmilk or dex-trose solution 10% was given into their mouth. Two independent observers, blinded to the intervention, assessed Premature Infant Pain Profile (PIPP) at 5 periods between 0-1st, 1st-2nd,2nd -3rd, 3rd-4th and 4th-5th minute after the painful stimulus. The primary aim was to compare PIPP score in the neonates when they received breastmilk versus dextrose solu-tion. Secondary outcome were the comparison of heart rate and oxygen saturation change, before and after the painful stimulus when breastmilk or dextrose solution was given.
RESULTS: A total of 23 neonates with mean gestational age 31 weeks and 5 days (range 26+1-36+3 weeks) and mean birth weight 1690 gr (range 900-2500gr) were recruited. The neonates presented lower mean PIPP score, when they received breastmilk in comparison with dextrose solution, in total ((p< 0.001) and at periods between 1st -2nd, 2nd -3rd, 3rd-4th, 4th -5th minute after the painful stimulus (p<0,05). Both heart rate and oxygen saturation were restored earlier to baseline values, following administration of breastmilk in compari-son with dextrose solution (p<0,05).
CONCLUSIONS: Our study showed that breastmilk has an advantage over dextrose 10% as an analgesic intervention before heel lancing in preterm neonates.
Keywords:
Breastmilk, Glucose solution, Analgesia, Premature neonates
