Non-pharmacological measures for pain relief in venipuncture in newborns: description of behavioral and physiological responses

Abstract

BACKGROUND AND OBJECTIVES: Venipuncture is considered a painful procedure, often performed in the neonatal intensive care unit. The objective of this study is to describe the behavioral and physiological responses of newborns undergoing venipuncture, with and without the use of non-pharmacological measures for the relief of pain. METHODS: A total of 84 newborns participated in this research. It was observed if the nurse prepared the newborn for the puncture. Newborns that did not receive the non-pharmacological approach were allocated in group 1, and those who received were to group 2. The behavioral and physiological parameters were assessed two minutes before and two minutes after the procedure in all newborns. The data analysis was descriptive. RESULTS: Before the procedure, 45.5% of the newborns in group 1 had a contracted face; however, after the procedure, this number increased to 69.7%. After the procedure in group 2, 29.4% grumbled, 3.9% had a vigorous cry, 66.7% did not cry. Arms and legs movement had similar responses in both groups. After the procedure, 72.7% of newborns in group 1 had a heart rate higher than 160bpm. After the procedure in group 1, 15.2% had an oxygen saturation between 96 and 100% and this value increase to 58.8% in group 2. Non-pharmacological measures for pain relief in venipuncture in newborns: description of behavioral and physiological responses Medidas não farmacológicas para alívio da dor na punção venosa em recém-nascidos: descrição das respostas comportamentais e fisiológicas Priscila Pereira de Souza Gomes1, Ana Paola de Araújo Lopes2, Maria Solange Nogueira dos Santos3, Silvania Moreira de Abreu Façanha4, Ana Valeska Siebra e Silva5, Edna Maria Camelo Chaves5 Priscila Pereira de Souza Gomes \ue9d9https://orcid.org/0000-0001-8743-145X; Ana Paola de Araújo Lopes \ue9d9https://orcid.org/0000-0001-5409-2543; Maria Solange Nogueira dos Santos \ue9d9https://orcid.org/0000-0002-8509-1989; Silvânia Moreira de Abreu Façanha \ue9d9https://orcid.org/0000-0002-7853-3160; Ana Valeska Siebra e Silva \ue9d9https://orcid.org/0000-0003-3664-5073; Edna Maria Camelo Chaves \ue9d9https://orcid.org/0000-0001-9658-0377. 1. Universidade Estadual do Ceará, Programa de Pós-Graduação Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brasil. 2. Universidade Estadual do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brasil. 3. Hospital Geral de Fortaleza, Fortaleza, CE, Brasil. 4. Universidade Estadual do Ceará, Mestrado Profissional em Saúde da Criança e do Adolescente, Fortaleza, CE, Brasil. 5. Universidade Estadual do Ceará, Fortaleza, CE, Brasil. Submitted on August 22, 2018. Accepted for publication on March 22, 2019. Conflict of interests: none – Sponsoring sources: none. Correspondence to: Av. Dr. Silas Munguba, 1700 Campus do Itaperi 60741-000 Fortaleza, CE, Brasil. E-mail: [email protected] © Sociedade Brasileira para o Estudo da Dor CONCLUSION: The behavioral and physiological responses presented by the newborns are altered when babies undergo venipuncture without the use of measures for the relief of pain, the most common being: contracted face; grumbling; arms and legs flexed/extended; tachycardia; and hyposaturation.