Effect of combined pharmacological, behavioral, and physical interventions for procedural pain on salivary cortisol and neurobehavioral development in preterm infants: a randomized controlled trial
Abstract
Repeated procedural pain may lead to increased secretion of cortisol and future neurobehavioral development disorders in preterm infants. Changes in cortisol level may mediate the effect of neonatal repetitive procedural pain on altered childhood neurobehavioral development in preterm infants. However, few studies have investigated the effect of combined pharmacological, behavioral, and physical interventions over repeated painful procedures on pain response, cortisol level and neurobehavioral development. The present study examined (1) the efficacy and safety of sucrose combined with massage, music, non-nutritive sucking and gentle human touch to treat preterm infants with repeated procedural pain; (2) cortisol level at discharge from the neonatal intensive care unit (NICU); (3) neurobehavioral development at 40 weeks' corrected gestational age; (4) the potential mediating effect of cortisol level in the combined interventions on neurobehavioral development. Stable preterm infants (n=76) were randomized to receive routine care or combined interventions across repeated painful procedures throughout their NICU stay. The preterm infant pain profile (PIPP) scores in the early, middle, and late periods of the NICU stay were measured, as were basal salivary cortisol level at admission and discharge, neonatal behavioral neurological assessment score at 40 weeks' corrected gestational age, and the incidence of adverse effects during the study period. Our findings indicated that the…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 76 participants or records.
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