Music and 25% glucose pain relief for the premature infant: a randomized clinical trial

Cardoso, Maria Vera Lúcia Moreira Leitão; Farias, Leiliane Martins; Melo, Gleicia Martins de

doi:10.1590/0104-1169.0029.2484

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 22 (5) • Sep-Oct 2014 • https://doi.org/10.1590/0104-1169.0029.2484 copy

Music and 25% glucose pain relief for the premature infant: a randomized clinical trial¹ 1 Paper extracted from doctoral dissertation "Effect of Music on Pain of Premature Newborns Submitted to Arterial Puncture" presented to Universidade Federal do Ceará, Fortaleza, CE, Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process # 483352/2011-0

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables.

METHOD:

a randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music), 33 in the Experimental Group 2 (music and 25% glucose), 23 in the Positive Control Group (25% glucose). All premature infants were videotaped and a lullaby was played for ten minutes before puncture in Experimental Groups 1 and 2; 25% glucose administered in Experimental Group 2 and the Positive Control Group two minutes before puncture.

RESULTS:

60.0% of premature infants had moderate or maximum pain; pain scores and intervention groups were not statistically significant. Statistically significant variables: Experimental Group 1: head and chest circumference, Apgar scores, corrected gestational age; Experimental Group 2: chest circumference, Apgar scores, oxygen therapy; Positive Control group: birth weight, head circumference.

CONCLUSION:

neonatal variables are associated with pain in premature infants. Brazilian Registry of Clinical Trials: UTN: U1111-1123-4821.

Infant; Neonatal Nursing; Randomized Controlled Trial; Pain

Intervention		Experimental Group 1		Experimental Group 2		Positive Control Group		Total		p-value*
Intervention		%	n	%		%	n	%	n	p-value*
Pain score
	≤ 6	7	29.2	14	42.4	11	47.8	32	40.0	0.398
	≥ 7	17	70.8	19	57.6	12	52.2	48	60.0	0.398

Intervention	Variables		PIPP pain score*				Total		p-value^†
			None/Minimum pain ≤ 6		Moderate/maximum pain ≥ 7		Total
			n	%	n	%	n	%
Experimental Group 1	Sex								0,647
		Male	4	57,1	12	70,6	16	66,7
		Female	3	42,9	5	29,4	8	33,3
		Total	7	100	17	100	24	100
	Type of birth								0,333*
		Normal	-	-	4	23,5	4	16,7
		C-section	6	85,7	12	70,6	18	75
		Forceps	1	14,3	1	5,9	2	8,3
		Total	7	100	17	100	24	100
Experimental Group 2	Sex								0,284
		Male	9	69,2	9	45	18	54,5
		Female	4	30,8	11	55	15	45,5
		Total	13	100	20	100	33	100
	Type of birth								0,456*
		Normal	4	30,8	10	50	14	42,4
		C-section	7	53,8	9	45	16	48,5
Experimental Group 2		Forceps	2	15,4	1	5	3	9,1	0,456*
Experimental Group 2		Total	13	100	20	100	33	100	0,456*
Positive Control Group	Sex								0,389
		Male	8	72,7	7	58,3	15	65,2
		Female	3	27,3	5	41,7	8	34,8
		Total	11	100	12	100	23	100
	Type of birth								1,000*
		Normal	2	18,2	3	25	5	21,7
		C-section	8	72,7	9	75	17	73,9
		Forceps	1	9,1	0	0	1	4,3
		Total	11	100	12	100	23	100

Variables	PIPP* Value	Mean±SD^†	95% CI^‡		Minimum	Maximum	p-value^¶
Variables	PIPP* Value	Mean±SD^†	IL^§	SL^\|\|	Minimum	Maximum	p-value^¶
Birth weight	≤6	2.380.6±581.4	2.115.9	2.645.2	1.336.0	3.054.0	0.077
	≥7	2.092.9±631.5	1.915.3	2.270.6	1.226.0	3.946.0
	Total	2.176.8± 672	2.029.4	2.324.2	1.226.0	3.946.0
Head circumference	≤6	32.8±2.1	31.8	33.8	29.5	35.0	0.003
	≥7	31.0±2.4	30.3	31.6	26.5	36.5
	Total	31.5±2.4	30.9	32.1	26.5	36.5
Chest circumference	≤6	29.4±3.1	28.0	30.9	23.0	32.0	0.032
	≥7	27.8±2.8	27.0	28.6	22.0	34.5
	Total	28.3±3.0	27.5	29.0	22.0	34.5
Number of punctures	≤6	1.0±0.0	1.0	1.0	1.0	1.0	0.080
	≥7	1.3±0.8	1.1	1.5	1.0	4.0
	Total	1.2±0.6	1.1	1.4	1.0	4.0
1’ Apgar	≤6	7.9±0.4	7.7	8.0	7.0	8.0	0.001
	≥7	6.2±2.2	5.6	6.8	2.0	9.0
	Total	6.7±2.0	6.2	7.2	2.0	9.0
5’ Apgar	≤6	8.7±0.5	8.5	8.9	8.0	9.0	0.047
	≥7	8.3±0.9	8.0	8.5	6.0	10.0
	Total	8.4±0.8	8.2	8.6	6.0	10.0
Corrected gestational age in weeks	≤6	35.2±1.4	34.5	35.8	32.6	36.3	0.003
	≥7	34.0±1.5	33.6	34.4	32.0	36.5
	Total	34.4±1.5	34.0	34.7	32.0	36.5
Corrected gestational age in days	≤6	247.1±9.2	243.0	251.3	230.0	255.0	0.008
	≥7	240.1±10.2	237.3	243.0	224.0	257.0
	Total	242.2±10.3	239.7	244.6	224.0	257.0
Cronological age in days	≤6	1.1±1.5	0.5	1.8	0.0	4.0	0.956
	≥7	1.2±2.6	0.4	1.9	0.0	9.0
	Total	1.2±2.3	0.6	1.7	0.0	9.0

Variables	PIPP* Value	Mean±SD^†	95% IC^‡		Minimum	Maximum	p-value^¶
Variables	PIPP* Value	Mean±SD^†	IL^§	SL^\|\|	Minimum	Maximum	p-value^¶
Birth weight	≤6	2.247.8±638.5	2.043.6	2.452.0	1.352.0	3.620.0	0.499
Birth weight	≥7	2.164.2±574.1	2.014.6	2.313.8	1.250.0	3.365.0	0.499
Birth weight	Total	2.198.0±599.2	2.078.5	2.317.5	1.250.0	3.620.0	0.499
Head circumference	≤6	31.7±2.6	30.9	32.5	26.0	36.0	0.267
	≥7	31.2±2.2	30.6	31.7	26.5	35.0
	Total	31.4±2.4	30.9	31.9	26.0	36.0
Chest circumference	≤6	29.9±3.6	28.7	31.0	25.0	39.0	0.002
	≥7	27.8±2.7	27.1	28.5	23.0	34.0
	Total	28.7±3.3	28.0	29.3	23.0	39.0
Number of punctures	≤6	1.2±0.4	1.0	1.3	1.0	2.0	0.291
	≥7	1.3±0.5	1.1	1.4	1.0	3.0
	Total	1.2±0.5	1.1	1.3	1.0	3.0
1’ Apgar	≤6	5.7±2.6	4.9	6.5	1.0	9.0	0.009
	≥7	6.9±1.9	6.4	7.4	3.0	9.0
	Total	6.4±2.3	6.0	6.9	1.0	9.0
5’ Apgar	≤6	8.1±1.0	7.7	8.4	6.0	10.0	0.002
	≥7	8.6±0.8	8.4	8.8	6.0	10.0
	Total	8.4±0.9	8.2	8.6	6.0	10.0
Corrected gestational age in weeks	≤6	34.7±1.4	34.2	35.1	32.4	36.6	0.078
	≥7	34.2±1.4	33.8	34.5	32.3	36.6
	Total	34.4±1.4	34.1	34.6	32.3	36.6
Corrected gestational age in days	≤6	243.8±10.0	240.6	247.0	228.0	258.0	0.064
	≥7	240.1±9.7	237.5	242.6	227.0	258.0
	Total	241.6±9.9	239.6	243.6	227.0	258.0

Variables	PIPP* Value	Mean±SD^†	95% IC^‡		Minimum	Maximum	p-value^¶
Variables	PIPP* Value	Mean±SD^†	IL^§	SL^\|\|	Minimum	Maximum	p-value^¶
Birth weight	≤6	1.996.5±432.3	1.850.2	2.142.8	1.396.0	2.999.0	0.045
	≥7	1.769.2±491.3	1.595.0	1.943.4	918.0	2.578.0
	Total	1.887.8±472.1	1.774.4	2.001.2	918.0	2.999.0
Head circumference	≤6	30.6±2.0	29.9	31.3	27.5	35.5	0.027
	≥7	29.1±3.4	27.8	30.3	20.0	32.6
	Total	29.9±2.9	29.2	30.5	20.0	35.5
Chest circumference	≤6	28.2±2.3	27.4	28.9	24.0	32.0	0.073
	≥7	26.7±4.1	25.3	28.2	20.0	34.0
	Total	27.5±3.3	26.7	28.3	20.0	34.0
Number of punctures	≤6	1.1±0.3	1.0	1.2	1.0	2.0	0.231
	≥7	1.2±0.4	1.0	1.3	1.0	2.0
	Total	1.1±0.3	1.0	1.2	1.0	2.0
1’ Apgar	≤6	6.6±1.6	6.0	7.1	4.0	9.0	0.661
	≥7	6.4±2.5	5.5	7.2	2.0	9.0
	Total	6.5±2.1	6.0	7.0	2.0	9.0
5’ Apgar	≤6	8.3±0.7	8.0	8.5	7.0	9.0	0.564
	≥7	8.4±0.9	8.0	8.7	7.0	9.0
	Total	8.3±0.8	8.1	8.5	7.0	9.0
Corrected gestational age in weeks	≤6	33.6±1.6	33.0	34.1	32.0	36.6	0.421
	≥7	33.9±1.7	33.3	34.5	32.0	36.6
	Total	33.7±1.7	33.3	34.1	32.0	36.6
Corrected gestational age in days	≤6	235.8±11.8	231.9	239.8	224.0	258.0	0.478
	≥7	237.9±12.4	233.5	242.3	224.0	258.0
	Total	236.8±12.0	233.9	239.7	224.0	258.0
Cronological age in days	≤6	4.3±11.1	0.5	8.0	0.0	40.0	0.175
	≥7	1.5±2.3	0.7	2.3	0.0	8.0
	Total	3.0±8.2	1.0	4.9	0.0	40.0

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[1] Corresponding Author: Maria Vera Lúcia Moreira Leitão Cardoso Universidade Federal do Ceará. Departamento de Enfermagem Rua Alexandre Baraúna, 1115 Bairro: Rodolfo Teófilo CEP: 60430-160, Fortaleza, CE, Brasil E-mail: cardoso@ufc.br