Pain
Conditions
Interventions
The study intervention consisted of the partial wrapping of the body in a sheet of 26 premature newborns during respiratory physiotherapy. As it is a cross-sectional study, all 26 participants were ev
Procedure/surgery
E02.779
Sponsors
Universidade São Francisco
Universidade São Francisco
Eligibility
Age
3 Days to 1 Months
Inclusion criteria
Inclusion criteria: The following inclusion criteria were considered: male and female preterm infants, gestational age of up to 37 weeks (<259 days), postnatal age greater than 72 hours of life, weight ?2,500 grams, and medical prescription to perform chest physiotherapy with the need for nasotracheal/endotracheal aspiration.
Exclusion criteria
Exclusion criteria: The following exclusion criteria were considered: infants under sedative effect, preterm infants with congenital malformations and/or external devices preventing modified swaddling, presence of convulsive seizures, use of surfactant, therapeutic hypothermia, and blood transfusion or any other conditions that presented contraindication for chest physiotherapy by the medical team. In this study, discontinuity occurred for participants who freed from the swaddle during the intervention or who were transferred to another ventilatory assistance device during the study follow-up period.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary end point was the assessment of the pain scale called the Neonatal Facial Coding System (NFCS) between the moment when the newborn's body was partially wrapped in a sheet versus the moment without the newborn's body wrapped in sheet. . On the NFCS scale, pain is characterized by a score greater than 3. In this context, it was expected that there would be a smaller number of participants with a score above 3 at the time the package was used for the physiotherapy maneuver.;The pain scale showed an increase in its value during physiotherapy maneuvers in the group without the wrap compared to the group with partial wrapping of the newborn's body. Additionally, only in the group without wrapping there were NFCS values ??above 3, considered the cutoff point for pain. | — |
Secondary
| Measure | Time frame |
|---|---|
| It was evaluated whether the modified wrapping during physiotherapy maneuvers increased oxygen saturation, heart rate and respiratory rate. Oxygen saturation (percentage of predicted) and heart rate (number of beats per minute) were analyzed using the Dixtal® oximetry monitor (Manaus, Amazon, Brazil), and respiratory rate (number of breaths per minute ), by measuring time on a local clock for 1 min. The markers were evaluated by changing the mean or median. In addition, the number of events in which each marker presented some change (abnormal value) was counted, namely: (i) oxygen saturation has a normal value of 91-95%; (ii) respiratory rate has a normal value equal to 30-60 breaths / min; (iii) heart rate has a normal value between 110-160 beats / min.;During the physiotherapy maneuvers there was no difference for the oxygen saturation, respiratory rate and heart rate markers. However, before starting the physiotherapy maneuver, in the group with wrapping, the participants had 6 points less (evaluated by the median) in the respiratory rate when compared to the group with wrapping. After the end of the physiotherapy maneuver, the participants in the group without wrapping had two more points (evaluated by the median) in oxygen saturation. | — |
Countries
Brazil
Contacts
Public ContactFernando;Patricia Marson;Carvalho
Universidade São Francisco;Universidade São Francisco
Outcome results
None listed