Document Detail


The use of non-nutritive sucking to decrease the physiologic pain response during neonatal circumcision: a randomized controlled trial.
MedLine Citation:
PMID:  16098887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this research was to study the effects on the physiologic pain response of the neonate during circumcision with the use of a gloved human finger. STUDY DESIGN: This was a randomized controlled trial analyzing the effect of non-nutritive sucking (NNS) on pain response during circumcision. Term neonates were randomized to 2 groups. All infants received oral Tylenol and a dorsal penile nerve block (DPNB) before the circumcision. The study group was offered the addition of NNS before the DPNB and throughout the procedure. The primary outcome measured was heart rate during the circumcision. Other variables studied included crying time and salivary cortisol levels. Each circumcision was filmed to calculate pain profile scores using the Premature Infant Pain Profile. Variables were compared using Student t test, chi-square, and Wilcoxon test. A P value of < .05 was considered significant. RESULTS: Forty-four infants met inclusion criteria. Twenty-two infants were randomized to each arm. No difference in mean heart rate during the procedure was apparent. A significant decrease in crying time, 90-minute post-procedure salivary cortisol level, and post-penile clamping pain score was noted in the study group (all P values < .01). CONCLUSION: NNS significantly decreases some elements of measurable physiologic pain response of the neonate during circumcision. This method is a useful and inexpensive addition to DPNB and oral analgesics.
Authors:
Mary M T South; Robert A Strauss; Andrew P South; John F Boggess; John M Thorp
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  193     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-15     Completed Date:  2005-09-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-42; discussion 542-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of North Carolina Hospitals, Chapel Hill, NC 27514, USA. msouth@unch.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Circumcision, Male
Crying
Heart Rate
Humans
Hydrocortisone / analysis
Infant, Newborn
Male
Pain / prevention & control*
Saliva / chemistry
Sucking Behavior*
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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