Physiological parameters after nonpharmacological analgesia in preterm infants: a randomized trial

Aim To compare the influence of three different nonpharmacological interventions on cortical activation, heart rate and peripheral oxygen saturation ( S a O 2 ) after heelstick in preterm infants. Methods Twenty five preterm infants between 24 0/7 and 32 0/7 weeks of gestational age were randomized to either oral sucrose ( S ), facilitated tucking ( FT ) or a combination of the two interventions ( SFT ) prior to five heelsticks each within the first 14 days of life. S a O 2 , heart rate and oxygenation of the somatosensory cortex, measured by near infrared spectroscopy ( NIRS ), were analysed. Results Hundred and twenty five heelsticks were performed. The heart rate increased significantly after heelstick in all three intervention groups (p < 0.004 in all groups). The increase was higher in the FT group compared with the other groups ( S : p = 0.007; SFT : p = 0.004). There was no difference among the two groups receiving sucrose (S and SFT ; p = 0.87). S a O 2 did not change significantly after heelstick in all intervention groups. Near infrared spectroscopy measurements did not show a significant change in the curve but patients in the FT group showed a trend towards higher average oxygenation of the contralateral somatosensory cortex. Conclusion Oral sucrose seems to be more effective in reducing reaction to pain than FT . Application of both interventions did not show an additive effect.