Résumé
Objectives: To compare individual efficacy and additive effects ofpain control interventions in preterm neonates.Design: Randomized controlled trialSetting: Level-3 University affiliated neonatal intensive care unit.Participants: 200 neonates (26-36 wk gestational age) requiringheel-prick for bedside glucose assessment. Exclusion criteriawere neurologic impairment and critical illness precluding studyinterventions.Intervention: Neonates were randomly assigned to Kangaroomother care with Music therapy, Music therapy, Kangaroo Mothercare or Control (no additional intervention) groups. All groupsreceived expressed breast milk with cup and spoon as a baselinepain control intervention.Main outcome measure: Assessment of pain using PrematureInfant Pain Profile (PIPP) score on recorded videos.Results: The mean (SD) birth weight and gestational age of theneonates was 1.9 (0.3) kg and 34 (2.3) wk, respectively. Analysisof variance showed significant difference in total PIPP scoreacross groups (P<0.001). Post-hoc comparisons using Sheffe’stest revealed that the mean (SD) total PIPP score wassignificantly lower in Kangaroo mother care group [7.7 (3.9) vs.11.5 (3.4), 95% CI(–5.9, –1.7), P<0.001] as well as Kangaroomother care with Music therapy group [8.5 (3.2) vs. 11.5 (3.4),95%CI (–5.1, –0.9), P=0.001] as compared to Control group.PIPP score was not significantly different between Control groupand Music therapy group.Conclusions: Kangaroo mother care with and without Musictherapy (with expressed breast milk) significantly reduces pain onheel-prick as compared to expressed breast milk alone. Kangaroomother care with expressed breast milk should be the first choiceas a method for pain control in preterm neonates.