Effect Evaluation Of Mother's Voice Combined With Non-nutritive Sucking In Neonatal Pain Management

ObjectiveTo observe the influence of mother's voice stimulation combined with non-nutritive sucking on the pain score and physiological indexes during heel blood collection in premature infants,in order to optimize the non-pharmaceutical intervention method for the management of heel pain in preterm infants.Methods120 newborn infants who met the inclusion criteria from Neonatal Ward of the Affiliated Hospital of Qingdao University since December 2017 to October 2018 were recruited.The newborns were randomly divided into four groups: mother's voice combined with non-nutritive sucking group,non-nutritive sucking group,mother's voice group and a control group.Each group consists of 30 newborns.The control group received routine treatment and nursing,while the intervention group were additionally given Mother's voice combined with non-nutritive sucking,non-nutritive sucking or Mother's voice respectively.The interventions given to the four groups began from 5 minutes before the heel collection to 10 minutes after the heel collection.The degree of pain in the four groups of preterm infants was assessed by the Newborn Pain Assessment Scale(NIPS);The changes in physiological indexes such as heart rate and blood oxygen saturation before blood collection,blood collection,and after blood collection were recorded;the number of premature infants crying were recorded.Statistical analysis was performed on the data using SPSS 17.0 software.The statistical methods used included chi-square test and analysis of variance.Results1.There was no significant difference in the general data characteristics in the four groups(P>0.05).2.The pain scores of preterm infants in NNS,MV group and MV+NNS group were lower than those in the control group(6.33±0.76 vs 6.83±0.38,P<0.05;6.20±0.76 vs 6.83±0.38,P<0.05;5.80±1.00 vs 6.83±0.38,P<0.05),the difference was statistically significant;The pain scores between MV+NNS group and MV group,MV+NNS group and NNS group(5.80±1.00 vs 6.20±0.76,P<0.05;5.80±1.00 vs 6.33±0.76,P<0.05), the difference was statistically significant;The pain scores of NNS group compared with MV group(6.33 ± 0.76 vs 6.20 ± 0.76,P<0.05),the difference was statistically significant.3.(1)The heart rate of the four groups of premature infants increased during the blood collection and within 2 minutes after the blood collection(P<0.05);Blood oxygen saturation decreased,compared with that before the heel collection,during the blood collection and within 4 minutes after the blood collection(P < 0.05);(2)There was no significant difference in the heart rate of four group before the heel blood collection(P>0.05);During heel blood collection and the last one minute,the heart of NNS,MV and MV+NNS is lower than the control group,the difference was statistically significant(P<0.05);The last two minute and three minute,there was no significant difference in the heart rate of four group(P>0.05).The time required for the heart rate of preterm infants in the NNS group,MV group and MV+NNS group to recover to the pre-blood collection level was less than that in the control group(101.87±8.87 vs 113.43±13.84,P<0.05;98.43±11.74 vs 113.43±13.84,P<0.05;88.63±9.36 vs 113.43±13.84,P<0.05);the time required for the heart rate of premature infants in the MV+NNS group to recover to the pre-blood collection level(seconds)was less than that in the NNS group and the MV group(P<0.05).(3)There was no significant difference in blood oxygen saturation between the four groups of preterm infants before blood collection(P>0.05);NNS group, MV group,MV+NNS in heel blood collection,1 minute,2 minutes and 3 minutes after blood collection the oxygen saturation of premature infants in the group was higher than that in the control group(P<0.05);The blood oxygenation in the MV+NNS group was higher than that in the NNS group at 1 minute,2 minutes and 3 minutes after blood collection(P<0.05).4.The number of premature infants crying in the MV group and MV+NNS group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion1.During the heel blood collection,non-nutritive sucking,mother ' s voice stimulation,the mother's voice stimulation combined with non-nutritive sucking can reduce the heel pain score in preterm infants.2.In the preterm infants during heel blood collection,non-nutritive sucking,mother's voice stimulation,mother's voice stimulation combined with non-nutritive sucking can stabilize the heart rate during heel blood collection process and 1 minute after blood collection;It can stabilize blood oxygen saturation during heel blood collection process and within 3 minutes after blood collection;It can shorten the time that the heart rate returned to normal.3.In the preterm infants during heel blood mother's voice stimulation,mother's voice stimulation combined with non-nutritive sucking reduce the number of crying.4.The three interventions of non-nutritive sucking,mother's voice stimulation,mother's voice stimulation combined with non-nutritive sucking during heel blood collection can alleviate pain.The analgesic effect of mother's voice combined with non-nutritive sucking is better than other two intervention.