ANALGESIC EFFECT OF 25% DEXTROSE VERSUS 25% DEXTROSE MIXED WITH EXPRESSED BREAST MILK (EBM) IN NEONATES DURING HEEL PRICK METHOD – AN OPEN LABELLED RANDOMISED COMPARATIVE CROSS SECTIONAL STUDY

Abstract

The experience of pain is a perplexing side effect of the human situation. As attitudes concerning pain have evolved over time, ways to relieve pain have been developed in conformity with scientific principles with the science and religious climate of the time 1Pain is an important issue for people of all ages but failing to recognise and treat pain in new-borns has long-term consequences in later stages of development. Although neonates don't verbally communicate their distress, evidence shows they feel pain but lack the adaptive mechanisms to cope with unpleasant stimuli and hence fail to express it. They use specific behaviours to demonstrate their propensity to pain and stress, while also physiological and biochemical responses to the pain caused 2. Pain can have both acute and chronic ramifications occur in infants, resulting in a range of neurological sequelae and affecting the baby's growth and development in early life. To reduce the acute and long - term repercussions of untreated pain in new-borns, there is a clear need for accurate intervention of pain and the challenges caused by pain. Multiple strategies have been suggested including pharmacological and non-pharmacological methods for pain relief treatments. Several concentrations of commercially available dextrose solutions were utilised 3. This study explores use of an orally administered quasi-biological fluid which is an acceptable method for to alleviate the procedural pain in the neonates. 3 MATERIALS AND METHODS This study was a randomized comparative cross - sectional study done on 158 babies. By using block randomization method neonates were divided into 2 groups to receive Solution A (2 ml of 25% dextrose orally) in one group and Solution B (1 ml of 25% dextrose and 1ml of expressed breast milk) orally in the other group. NIPS (Neonatal Infant Pain Scale) scoring was used to monitor the neonates during heel prick procedures. RESULTS 158 babies were considered in preparation for the evaluation process with 79 babies in the 25% dextrose taken as solution A group and 79 babies in the 25% dextrose and EBM (Expressed breast milk) in equal amounts taken as solution B group after block randomisation by computerised method. Different time periods for saturation between the study groups showed significant reduction in pain with 25 %dextrose and EBM solution merged at the conclusion of 1 min and 3 min i.e., 96.3 ± 2.55 and 97.71 ± 1.17 (p = 0.001). The overall NIPS score at 1, 3 and 5 min were significant with p value < 0.0001 for the solution B using 25 % dextrose and EBM. 4 CONCLUSION Pain was significantly reduced in both solution A (25 percent dextrose) and solution B (25 percent dextrose mixed with EBM), though an equal mixture of 25 percent dextrose and EBM (expressed breast milk) proved to be a better pain alleviating mixture in neonates when assessed by NIPS score as compared to 25 percent dextrose alone to alleviate pain during the heel prick procedures in neonates.