Abstract
BackgroundPreterm neonates undergo many painful procedures as part of their standard care in the neonatal intensive care unit. However, pain treatment is inadequate in many of these routine procedures. In the present study, we investigated the impact and mechanism of combined music and touch intervention (CMT) on the pain response in premature infants.MethodsSixty-two preterm neonates (gestational age of <37 weeks) were randomly assigned to either the experimental or control group. Infants in the experimental group underwent painful procedures with CMT, and those in the control group underwent painful procedures without CMT. Blood samples were collected from all infants at the beginning of hospitalization and 2 weeks later to assess the cortisol and β-endorphin concentrations. Differences in the levels of cortisol and β-endorphin between two groups were examined using analysis of covariance (ANCOVA).ResultsIn total, 3707 painful procedures were performed on 62 neonates during their hospitalization. The average number of painful procedures in the control group (n = 35.5) was higher than that in the experimental group (n = 29.0) during hospitalization, although no significant difference was reached (P > 0.05). After 2 weeks, the Premature Infant Pain Profile scores were significantly higher in the control group than experimental group (13.000 ± 0.461 vs 10.500 ± 0.850, respectively; P < 0.05). The cortisol concentration was not significantly different between the control and experimental groups either at the beginning of hospitalization (131.000 ± 18.190 vs 237.200 ± 43.860, respectively; P > 0.05) or 2 weeks later (162.400 ± 23.580 vs 184.600 ± 21.170, respectively; P > 0.05). However, the serum β-endorphin concentration was higher in the experimental group than in the control group both at the beginning of hospitalization (1.640 ± 0.390 vs 1.179 ± 0.090, respectively; P < 0.05) and 2 weeks later (2.290 ± 0.740 vs 1.390 ± 0.410, respectively; P < 0.05).ConclusionsCMT might decrease the pain response of preterm neonates by significantly improving the β-endorphin concentration, but not the blood cortisol concentration.Trial registrationCurrent Controlled Trials ISRCTN14131492. Registered on 01 Aug 2016.
Highlights
Preterm neonates undergo many painful procedures as part of their standard care in the neonatal intensive care unit
In China, no study has addressed the effects of combined music and touch intervention (CMT) on the pain response in late preterm infants
We studied the levels of cortisol and β-endorphin after the intervention because these parameters may provide evidence of the effectiveness of CMT in alleviating pain in premature infants
Summary
Preterm neonates undergo many painful procedures as part of their standard care in the neonatal intensive care unit. We investigated the impact and mechanism of combined music and touch intervention (CMT) on the pain response in premature infants. Music therapy may help to relieve procedural pain in both full-term and preterm infants because it can provide an auditory stimulus that modulates pain perception, obviating or decreasing the need for pharmacological agents [10, 12, 13, 15, 16] Another nonpharmacological intervention, touching, helps to reduce pain in preterm and term neonates. In China, no study has addressed the effects of combined music and touch intervention (CMT) on the pain response in late preterm infants. We studied the levels of cortisol and β-endorphin after the intervention because these parameters may provide evidence of the effectiveness of CMT in alleviating pain in premature infants. This circulatory release of β-endorphin can be reduced by systemic analgesia [23,24,25]; plasma β-endorphin concentrations have frequently been used to determine analgesic efficacy
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