• Acta paediatrica · May 2009

    Variability in pain response to a non-pharmacological intervention across repeated routine pain exposure in preterm infants: a feasibility study.

    • E Cignacco, K Denhaerynck, M Nelle, C Bührer, and S Engberg.
    • Institute of Nursing Science, University of Basel, Basel, Switzerland. eva.cignacco@unibas.ch
    • Acta Paediatr. 2009 May 1;98(5):842-6.

    AimTo explore the variability in pain response in preterm infants across time who received sucrose during routine heel stick.MethodSingle group, exploratory repeated measures design.SettingTwo tertiary level neonatal intensive care units (NICU) in Switzerland.SubjectsNine preterm infants born between 28 2/7 and 31 4/7 weeks of gestation during their first 14 days of life.MeasurementsPain was assessed by the Bernese Pain Scale for Neonates (BPSN), the Premature Infant Pain Profile (PIPP) and the Visual Analogue Scale (VAS). Salivary cortisol was analysed.Results72-94% of the variability was within-subject variability, indicating inconsistency of pain responses across the 5 heel sticks. Interrater agreement was highest during heel sticks 1-3 and decreased during heel stick 4 and 5, indicating a possible alteration of pain patterns. No significant differences in the amount of cortisol could be detected before and after the heel sticks (p = 0.55), indicating no stress-induced peak after the painful intervention. However, a general gradual decrease of cortisol levels across time could be detected.ConclusionA high variability in pain response among preterm neonates across time could be described. Consistency of cortisol levels before and after the heel sticks could indicate the effectiveness of sucrose across time.

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