THE ANALGESIC EFFECT OF ORAL GLUCOSE AND BREAST FEEDING DURING PROCEDURAL PAIN IN NEONATES
ABDELMONEIM E. M. KHEIR *
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Soba University Hospital, P.O.Box 102, Khartoum, Sudan
EHSAN O. A. ATTYIA
Department of Neonatology, Soba University Hospital, Sudan
FATIMA M. A. ABUNURA
Department of Paediatrics, Omdurman Islamic University, Sudan
*Author to whom correspondence should be addressed.
Abstract
Background and Objective: Newborns experience pain and that controlling newborn pain has short and long-term benefits. The objective of our study was to comparatively evaluate the analgesic effect of breastfeeding and oral glucose solution during painful procedures in term neonates.
Methods: This was an observational, comparative, hospital based study that was carried out in Soba University Hospital in Khartoum state, Sudan, from December 2016 to June 2017. A total of 200 neonates were included in this study, they were divided equally into two groups, oral glucose solution group and breast feeding group. Data was collected by Questionnaire and scoring system using Premature Infant Pain Profile (PIPP). Physiologic data including heart rate and transcutaneous oxygen saturation were collected by pulse oximetry and neurobehavioral state components of the PIPP were taken before and after the painful procedure. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Chi square test was used to compare the pain score between the two groups. P value was set at 0.05 level of significance.
Results: The present study revealed that the maximum heart rate increase after the painful procedures was between 0-4 beat per minute in 71(71%) neonates in the breast feeding group and 79 (79%)in the other group with no significant difference between the two groups (P value = 0.204). The drop in O2 saturation was between 0-2.4% in 98 (98%)neonates of the breast feeding group and 95 (95%)neonates in the oral glucose group, drop between 2.5% and 0-4.9% was demonstrated in only 2 neonates of the breast feeding group and 5 neonates in the oral glucose group with no significant association between the two groups( P=0.248). The brow bulge and nasolabial furrow scoring in the PIPP score showed similar results with no significant association between the two groups (P=0.430 and 0.390 respectively). When the pain score was applied using the PIPP, there was no significant difference between the two groups.
Conclusion: Both breast feeding and oral glucose solution effectively reduced procedural pain in term neonates with no significant differences between the two groups when measured by composite pain indicators using the PIPP scale.
Keywords: Pain, analgesia, neonates, glucose, breast feeding