Neonatal Pain Management and Pain Monitoring Using New Methods

NCT ID: NCT04967118

Last Updated: 2023-11-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-02

Study Completion Date

2024-12-31

Brief Summary

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The aim of this randomized controlled study with crossover design is to examine the effectiveness of mother-driven interventions, skin-to-skin contact (SSC) and recorded mother's heartbeats as sound and vibration (MHB), compared to oral glucose in relieving neonatal acute pain related to heel lance as a painful procedure.

The effectiveness of interventions will be assessed using validated pain scales (PIPP-R and NIAPAS), changes in sensory cortex activation (near-infrared spectroscopy, NIRS) and changes in physiological indicators (oxygen saturation, heart rate, respiratory rate). The secondary objectives will include evaluating the effectiveness of interventions in relation to infant recovery and evaluating the use of NIRS monitoring in relation to neonatal pain assessment scales.

Detailed Description

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Conditions

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Pain, Acute Procedural Pain Infant

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

A crossover design with each child as his or her own control will be used to minimize interchild variability. Order of interventions will be randomly assigned by computer-generated program.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Two research assistants (NICU nurses) who are blinded to the intervention condition (30% oral glucose and combination of 30% oral glucose and the mother's heartbeat intervention) will be perform calculation of infant PIPP-R and NIAPAS scores independently. Calculating NIAPAS scores will requires observation of the neonate's body, so during the skin-to-skin contact the intervention condition cannot be blinded. NIRS signals will be analyzed by researchers who are unaware of the nature of intervention and whether they are analyzing a noxious or non-noxious stimulation. To minimize observer bias, research assistants and researchers analyzing the NIRS signal will not be permitted to attend data collection sessions and will not share datasets or communicate with each other regarding the study.

Study Groups

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Skin-to-skin contact

Neonates will be placed ventral skin-to-skin position with their mother at least thirty minutes prior the heel lance to give time to calm down following transfer. Skin-to-skin positioning will be taken account comfortable position as possible for mother and the baby, easy to access heel for blood sample and interference minimizing during video recording and continuous NIRS, ECG and oxygen saturation measurement. Skin-to-skin contact will be continued for approximately fifteen minutes after completion of blood sampling. In addition, the neonates will be given a 30% oral glucose solution two minutes prior the heel lance.

Group Type EXPERIMENTAL

Skin-to-skin contact

Intervention Type BEHAVIORAL

Diaper clad baby will be placed ventral position on bare chest of mother 30 minute prior to the heel lance

Mother's heartbeats as sound and vibration

Neonates will be placed in an incubator or a cot, depending on their gestational age, and will be supported on side position by nest-shaped rolls according to department's normal practice. The platform on which the mother's heartbeat will be played will be placed under mattress of the incubator or crib. The playing of the mother's recorded heartbeats will be started thirty minutes prior the heel lance and will be continued during and fifteen minutes after the blood sampling. In addition, the neonates will be given a 30% oral glucose solution two minutes prior the heel lance.

Group Type EXPERIMENTAL

Mother's heartbeats as sound and vibration

Intervention Type BEHAVIORAL

The mother's heartbeat will be recorded and the heartbeat sounds will be saved to the platform. The platform will be placed under the infant's mattress and the heartbeat will be started 30 minute prior to the heel lance.

30% oral glucose

Neonates will be placed on in an incubator or a cot, depending on their gestational age, and will be supported on side position by nest-shaped rolls according to department's normal practice. The neonates will be given a 30% oral glucose solution two minutes prior the heel lance

Group Type ACTIVE_COMPARATOR

30% oral glucose

Intervention Type DRUG

The infant will be given 30% oral glucose solution 2 minutes before the injection

Interventions

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Skin-to-skin contact

Diaper clad baby will be placed ventral position on bare chest of mother 30 minute prior to the heel lance

Intervention Type BEHAVIORAL

Mother's heartbeats as sound and vibration

The mother's heartbeat will be recorded and the heartbeat sounds will be saved to the platform. The platform will be placed under the infant's mattress and the heartbeat will be started 30 minute prior to the heel lance.

Intervention Type BEHAVIORAL

30% oral glucose

The infant will be given 30% oral glucose solution 2 minutes before the injection

Intervention Type DRUG

Other Intervention Names

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Kangaroo Mother Care Sweet taste

Eligibility Criteria

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Inclusion Criteria

* Gestational Age (GA) at birth 32+0 - 42+0
* Admitted to NICU
* Parents are able to read, write and speak Finnish

Exclusion Criteria

* With a postnatal age of 14 days or more
* Apgar points were 6 or less at 5 minutes of age
* Has been found grade III or IV cerebral haemorrhage
* Major congenital anomalies
* Has intubated or receiving a nCPAP
* Has received analgesics or sedatives for less than 24 hours prior to the study
Minimum Eligible Age

32 Weeks

Maximum Eligible Age

42 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oulu

OTHER

Sponsor Role lead

Responsible Party

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Anna-Kaija Palomaa

PhD researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Oulu University Hospita

Oulu, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Anna-Kaija Palomaa

Role: CONTACT

Phone: +358400892159

Email: [email protected]

Facility Contacts

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Anna-Kaija Palomaa

Role: primary

Tarja Pölkki, profesor

Role: backup

Other Identifiers

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296/2018

Identifier Type: -

Identifier Source: org_study_id