Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose.

BACKGROUND AND OBJECTIVES: Inadequate pain assessment in preterm infants (PI) is a persistent problem. Currently, a precise pain assessment is one of the main challenges for health professionals in the intensive care units (NICU). The objective of this study was to verify the correlation between the Neonatal Infant Pain Scale (NIPS) and Premature Infant Pain Prole - Revised (PIPP-R), internal consistency, and inter-evaluator reliability on pain assessment during aspiration in PI. METHODS: Prospective observational study with low birth weight PI (< 2500 g), hemodynamically stable, minimal or no sedation, under mechanical ventilation, continuous positive airway pressure, nasal cannula oxygen, or ambient air, and needing aspiration during hospitalization in the neonatal intensive care unit in the period from 2019 to 2020.. PI were evaluated during three different aspiration procedures: without intervention (1), using gentle touch (2), and using sucrose (3). NIPS and PIPP-R instruments were applied, while internal consistency was determined using Cronbach’s alpha, reliability using the intraclass correlation coefficient, and concurrent validity using Spearman’s correlation coefficient. RESULTS: Fifty PIs requiring tracheal aspiration were evaluated. NIPS and PIPP-R showed high (Cronbach α: 0.824) and moderate (Cronbach α: 0.655) internal consistency. Inter-e- valuation reliability was excellent in all aspiration procedures for NIPS (1: 0.991, 2: 0.987, and 3: 0.993) and PIPP-R (1: 0.997, 2: 0.986, and 3: 0.977). Concurrent validity was observed only for aspiration without intervention. CONCLUSION: Although NIPS may have better clinical utility than PIPP-R, both instruments presented good internal consistency and inter-evaluator reliability and may be used for assessing pain during aspiration in PI.