Effect of kangaroo mother care on pain during orogastric tube insertion in low-birthweight newborns: An open label, randomised trial.

Abstract

Non-pharmacological methods are commonly used to reduce the procedural pain in newborns. In this open label, randomised control trial, we studied the pain-reducing effect of kangaroo mother care (KMC) during orogastric tube insertion. Newborns, with birthweight 1500-2499 g and admitted to nursery, were randomised into control (no-KMC) or intervention (KMC) arms. In intervention arm, KMC was given for 60 min before and after the procedure. Premature Infant Pain Profile-Revised (PIPP-R) score was used to assess the pain response and the pain severity was graded as minimal or no pain (≤6), mild-to-moderate (7-12) and severe (>12). The PIPP-R scoring was done before, during and at 3- and 15-min after procedure. Change in PIPP-R scores from baseline was calculated. Newborns included in no-KMC (n=40) or KMC (n=40) arms were comparable for major confounders (P > 0.05). Pre-procedural pain scores were comparable (P=0.72). Pain scores measured during and after procedure were significantly higher in no-KMC group than KMC arm. The KMC reduced the pain score by 39%, 32% and 30% during and at 3- and 15-min after procedure respectively as compared to control (P < 0.01). The increase in PIPP-R score from pre-procedural level was 40%, 35% and 31% lower in KMC than no-KMC arm (P < 0.01). A greater proportion of newborns had significantly less severe grades of pain in the intervention arm compared to the no-KMC arm (P < 0.01). Orogastric tube placement is a painful procedure. KMC significantly reduces periprocedural pain and its effect continues for at least 15min after the procedure.