A comparative study of nonpharmacological methods to reduce pain in neonates.

A randomized study was done to compare non pharmacological methods to reduce the pain of heel pricks in 104 stable term neonates. Non-nutritive sucking (NNS), rocking, massage, sucrose (20 percent), distilled water (DW) and expressed breast milk (EBM) were used as pain reducing agents. Duration of cry and Douleur Aiguë du Nouveau né (DAN) score were used to assess pain. Physiological parameters were also recorded before and after the stimulus. At 30 seconds after the stimulus, the pain scores were lowest in the sucrose group but this was not sustained at 1, 2 and 4 minutes. At 2 and 4 minutes pain scores were lowest in the NNS and rocking groups as compared to sucrose, distilled water, expressed breast milk and massage. The total duration of crying was also lowest in the NNS and rocking groups. Physiological parameters were comparable in all groups. Babies who were in Prechtl State 1 and 2 (sleeping) at the time of stimulus showed significantly lesser response to pain compared to babies who were awake. This was seen in all the intervention groups. In conclusion, our study suggests that rocking or giving a baby a pacifier are more effective non-pharmacological analgesics than EBM, DW, sucrose or massage for the pain of heel pricks in neonates. A calm or sleeping state before a painful procedure also appears to decrease crying and pain scores.

Caffeine in tea plants [Camellia sinensis (L) O. Kuntze]: in situ lowering by Bacillus licheniformis (Weigmann) Chester.

Tea plants (Camellia sinensis) contain 5-6% caffeine that is responsible for the stimulating effect of the beverage. As the tolerance to caffeine varies among individuals, low caffeine tea would be an ideal alternative. While assessing the potential of a few selected bacteria-Bacillus licheniformis, B. subtilis and B. firmus, to multiply on nutrient medium supplemented with glucose (5%) and tea leaf extract (2%), it was observed that only B. licheniformis could proliferate on this medium. Hence, B. licheniformis was used for further studies. Tea plants were sprayed with a suspension of B. licheniformis at a dilution of 5 x 10(8) CFU/ml containing 0.1% Tween 80 as surfactant. In situ lowering of caffeine from tea leaves was evident without affecting the quality of the other tea components. Further, there was no change in the morphological and physiological characteristics as well. It is suggested that spraying of B. licheniformis may be useful in yielding decaffeinated tea with good flavour and aroma.