Skip to main content

Massage and Swaddling Reduce Pain in Infants

25 may 2012, Massage can reduce the child's arms and hands and diapers clearly the painful needle sticks, two recent studies - May 2012 (Honolulu, Hawaii).

In one study, researchers massaging upper limbs of children in a neonatal intensive care unit (NICU) before administration of venipuncture for blood samples.
In the second study, wrapped in blankets researchers from the children a heel stick.
Both teams of researchers have investigated the pain of babies in the Neonatal Pain Profile (PIPP), a composite measure of heart rate, oxygen saturation, facial reactions to pain (grimacing, brow bulge, nasolabial folds and lips pursed), behavioral state and gestational age.
The researchers reported the results of both studies at the American Pain Society (APS) annual scientific meeting .. 31
Babies with
Doctors often adhere to the NICU babies with needles to test your blood or administer medication."In my clinical practice I have seen many children suffer," Yuen Mon Chik, MS, lead author of the massage parlor, told Medscape Medical News: "I wonder if there is a way to relieve pain."
It can be difficult to give babies oral analgesics, Chik said a researcher at the U.S. Christian Hospital, Hong Kong, China. "In foreign hospitals, such as the use of sucrose. It is effective in some ways, but in some babies it is not appropriate for the immature gut."
For the study of massage, Chik and his colleagues randomly 65 children with a gestational age 30 to 40 weeks divided into two groups. The 32 children in group 1 received a massage for 2 minutes before the first blood test. They have the usual treatment before his second venipuncture.
In group 2, the order reversed - the usual care following massage.
The researchers tracked babies behavior and physiological responses to an accountant in real time, right after the massage, and again in the first 30 seconds of sampling.
A nurse who did not want the child a massage before venipuncture rated videos and biometric data of children and had met in PIPP. Scores of PIPP ranging from 0 to 21, wherein higher values ​​indicate higher pain behaviors.
The average pain score in the first group was 5.84 ± 3.51 and 12.66 ± 3.10 a massage without any massage. The respective values ​​of the second group, 7.30 ± 4.43 and 11.33 ± 4.37.
The researchers concluded that the technique effectively reduces the pain of babies. "After a massage, there appears to be no sorrow," says Chik.
Kathleen Sluka, Ph.D., professor of physical therapy and rehabilitation science of pain at the University of Iowa in Iowa City, told Medscape Medical News that he was impressed that massage seems to reduce pain score as much as half.
"This is a relatively large reduction in pain for something as simple as a 2-minute massage," says Sluka, who was not involved in the study. "It's very easy to do."
She said that children who are prone to suffer from chronic pain, pain that develop in adulthood. "This can be very important from this perspective," he said.
Wrap
In the second study, so researchers at the Chinese University of Hong Kong, China, the impact of diapers for newborns. They included 27 randomized 27 preterm infants with and without intervention.
They report that the average values ​​were lower in the intervention group PIPP than in the control group during, immediately after and 2, 4 and 6 minutes after a heel stick (p = 0.001).
The average heart rate and oxygen saturation was also lower in the intervention group than in the control group in all these points in time (p <.001).
Both heart rate and oxygen saturation in infants in diapers back to baseline levels in 2 minutes, but lasted for 6 to 8 minutes for these guys back to baseline in the control group.
The researchers do not show any side effects.Speculate that the proprioceptive sensory stimulation systems provide diapers, thermal and tactile pain can be achieved by control of the door to be reduced.
Wrap perhaps less practical than massage because it is difficult to access veins of babies wrapped in blankets, Chik said.
American Pain Society (APS) 31 th annual scientific meeting. Abstract # 333 and # 455th Presented at 16th May 2012.
Ms. Chik, and Ms. Sluka has NOTHING relevant financial relationships.

Comments

Post a Comment

Popular posts from this blog

Missing Data Lead FDA Panel to Vote Against Rivaroxaban for ACS May 23, 2012 (Updated May 24, 2012) (Silver Spring, Maryland) — The missing data issues plaguing the ATLAS ACS 2 TIMI 51 trial of the factor Xa inhibitor rivaroxaban (Xarelto, Bayer Healthcare/Janssen Pharmaceuticals) have prevented the drug from earning the endorsement of the FDA Cardiovascular and Renal Drugs Advisory Committee. At its May 23 meeting, the panel voted six to four (with one abstention) against recommending that the FDA approve rivaroxaban for reducing the risk of thrombotic cardiovascular events in patients with acute coronary syndrome or unstable angina in combination with aspirin, aspirin plus clopidogrel, or ticlopidine. Janssen's application is based on the results of the ATLAS ACS 2 phase 3 and the ATLAS ACS TIMI 46 phase 2 trial. The placebo-controlled ATLAS ACS 2 showed rivaroxaban reduced the risk of both all-cause and cardiovascular mortality while increasing the risk of bleeding and intracranial hemorrhage, but the studies were hindered by early patient withdrawals and missing data. We Don't Know What We're Missing Based on the ATLAS ACS 2 results, FDA reviewer Dr Karen Hicks recommended approval of rivaroxaban for the requested indications except all-cause mortality. However, another FDA reviewer, Dr Thomas Marciniak, was adamant that the trial results are not interpretable because about 12% of the patients had incomplete follow-up, far higher than the 1% to 1.5% differences in the end-point rates between rivaroxaban and placebo. A total of 1294 subjects discontinued the trial prematurely, and the company was only able to contact 183, of which 177 were confirmed to be alive. Because of the patient dropouts, the company adopted a "modified intention-to-treat analysis," whereby patients were observed for 30 days after randomization or the global end date for the trial, instead of observing all the patients until the end of the trial as the FDA originally suggested. Marciniak criticized the sponsor's efforts to follow the patients and said that three patient deaths not counted in the modified intention-to-treat analysis may just be the "tip of the iceberg." Because the percentage of patients whose ultimate vital status remains unknown is much greater than the reported differences in mortality rates, the claimed mortality benefits are not reliable. The majority of the panel sided with Marciniak. For example, Dr Sanjay Kaul (University of California, Los Angeles) voted "no" because "there was enough uncertainty in the quality and robustness of the data that dissuaded me from voting yes. . . . The 'missingness' of the data doesn't invalidate it, but it certainly makes it hard to infer [the conclusion]." Dr Steven Nissen (Cleveland Clinic, OH) said that the decision to use the modified intention-to-treat analysis had a "profound impact" on the interpretability of the data. "It's saying we don't care what happens after 30 days, [and] that colored the trial in ways we couldn't recover from." Given the risk of major bleeding, "I want to see better evidence that this strategy of adding an Xa inhibitor or a direct thrombin inhibitor or something else to a good antiplatelet agent is robustly better for the patient," Nissen said. He recommends that the companies run a new trial of the 2.5 twice-daily dose of rivaroxaban using a strict intention-to-treat approach, but, he said, "I don't expect the death benefit to be too robust." Several panelists said they were concerned that the patients who dropped out of the trial were disproportionately likely to have a bleeding event, which led them to quit the trial, or a "protopathic" event, as statistician Dr Scott Emerson (University of Washington, Seattle) put it. "We're worried that an impending event is what is changing their behavior. We see that all the time in clinical trials--that regularly measured end points do not pick up [all of] the events," he said. He said that since the company was only able to contact 183 of the over 1200 patients who dropped out, it is possible that the dropouts skew the outcomes comparison of the trial. "Differential event rates after dropout are the number-one thing we're afraid of, so you have to explore it" in a statistical sensitivity analysis of the potential impact of these unknown outcomes. "It would not surprise me if, at the end of the day, these data did not hold up under a proper sensitivity analysis," he said. "What I want to know is, among the people who had events, how differential was the follow-up, but I can tell you by just looking at it, there was a very slightly different amount of follow-up of the people in the treatment arm. But I don't know whether everyone in the treatment arm was cured and they were trekking in the Himalayas and everyone in the placebo arm went home to die. I don't know that that's not the case." Dr Maury Krantz (University of Colorado, Denver) voted in favor of approval but said he does not know how rivaroxaban would perform in general clinical practice, especially when used with aspirin and clopidogrel. "I felt very much torn by this. This isn't a simple paradigm shift. It means going to triple therapy, which is really a three-headed monster in many ways. I think that what you're going to see in practice, if this is not done carefully with the proper labeling and secondary studies, is really dramatic magnification of bleeding and perhaps minimization of the efficacy benefit."

May 23, 2012   (Updated May 24, 2012)  (Silver Spring, Maryland)  —  The missing data issues plaguing the  ATLAS ACS 2 TIMI 51   trial of the factor Xa inhibitor  rivaroxaban  (Xarelto, Bayer Healthcare/Janssen Pharmaceuticals) have prevented the drug from earning the endorsement of the  FDA  Cardiovascular and Renal Drugs Advisory Committee. At its May 23 meeting , the panel voted six to four (with one abstention) against recommending that the FDA approve rivaroxaban for reducing the risk of thrombotic cardiovascular events in patients with acute coronary syndrome or unstable angina in combination with aspirin, aspirin plus  clopidogrel , or  ticlopidine . Janssen's application is based on the results of the ATLAS ACS 2 phase 3 and the  ATLAS ACS TIMI 46   phase 2 trial. The placebo-controlled ATLAS ACS 2 showed rivaroxaban reduced the risk of both all-cause and cardiovascular mortality while increasing the ri...

Antidepressants Linked to Higher Diabetes Risk in Kids

Pediatric patients who use antidepressants may have an elevated risk for type 2 diabetes, the authors of a new study report. In a retrospective cohort study of more than 119,000 youths 5 to 20 years of age, the risk for incident type 2 diabetes was nearly twice as high among current users of certain types of antidepressants as among former users, Mehmet Burcu, PhD, and colleagues report in an article  published online October 16 in  JAMA Pediatrics . The risk intensified with increasing duration of use, greater cumulative doses, and higher daily doses of these antidepressants. The findings point to a growing need for closer monitoring of these products, including greater balancing of risks and benefits, in the pediatric population, the authors caution. They undertook the study because, despite growing evidence of an association between antidepressant use and an increased risk for type 2 diabetes in adults, similar research in pediatric patients was scarce. "To our know...

Contact Precautions May Have Unintended Consequences

Contact precautions, including gloves, gowns, and isolated rooms, have helped stem the transmission of hospital pathogens but have also had some negative consequences, according to findings from a new study. Healthcare worker (HCWs) visited patients on contact precautions less frequently than other patients and spent less time with those patients when they did visit, report Daniel J. Morgan, MD, from the University of Maryland School of Medicine and the Veterans Affairs (VA) Maryland Health Care System, Baltimore, and colleagues. Moreover, patients on contact precautions also received fewer outside visitors. "Less contact with HCWs suggests that other unintended consequences of contact precautions still exist," Dr. Morgan and coauthors write. "The resulting decrease in HCW contact may lead to increased adverse events and a lower quality of patient care due to less consistent patient monitoring and poorer adherence to standard adverse event prevention methods (such...