Time of Music in Newborn Pain: Randomized Clinical Trial

Sunday, 28 July 2019: 3:40 PM

Maria Vera Lúcia Moreira Leitão Cardoso, PhD
Nursing Department, Federal University of Ceará, Fortaleza, Brazil
Gleicia Martins Melo, PhD
Department of Nursing, Federal University of Ceará, Fortaleza, Brazil

Purpose: to assess the effect of music intervention when applied in two time extensions on behavioral responses of pain in full-term newborns before, during and after the venipuncture for blood collection.

Methods: A randomized clinical trial carried out in a private maternity from February/December/2017 in Brazil. The sample consisted of 52 full-term newborns hospitalized in Rooming-in, being 13 randomized on each group: Music Group 1 (MG1- with music for 10 minutes); Music Group 2 (MG2 - with music for 15 minutes); Control Group 1 (CG1-without music, for 10 minutes) and Control Group 2 (CG2 - without music, for 15 minutes). The randomization occurred through four envelopes sealed and identified with the name of group allocation. A member of nursing team, randomly choose one envelope with the intervention to be administered. The professional responsible by blood collection and the statistical analysis were blind.Two lullaby songs from the collection Music Baby: Bonne Nuit were played in 40 decibels, by MP3 and earphones on MG1 and on MG2, for 10 and 15 minutes before, during (whilst the painful procedure lasts) and two minutes after. The CG1 and CG2 also used earphones. The newborns participating were videotaped to get facial reactions. The measured variables were facial mimic from the Neonatal Facing Coding Scale (NFCS) and crying. Data collect was carried out in five moments using NFCS: Basal (BM - 20 initial seconds - without handling), Pre-procedure 1 (PPM1 - 20 initial and final seconds, each), Pre-procedure 2 (PPM2 - vein search time), Procedure (PM - antisepsis, puncture, squeezing/blood aspiration and compression time) and Recovery (RM - 20 initial and final seconds after end of compression); five moments for crying: BM (2 minutes), PPM1(2 initial and final minutes), PPM2 (vein search time), PM (antisepsis, puncture, squeezing/blood aspiration and compression time) and RM (2 minutes). The presence of crying was considered as any audible vocalization with duration higher five seconds and pause interval until 20 seconds. Project approved by the Research and Ethics Committee of the institution.

Results: As for the neonatal variables (categorical and numeric), there were significant statistics between allocation groups only for the therapeutic variable (puncture site) (p = 0.003). Pearson Qui-Square Test showed that, the percentage of facial mimic absence (brow bulge, narrow eyes, deepened nasolabial furrow, horizontal opened mouth, taut tongue) was significantly higher on MG2, when compared to the other groups, in all moments analyzed (p< 0.05), it shows that in this group the expression of pain was lower.The comparison between music group (MG1,MG2) and group without music (CG1, CG2) using NFCS scale showed that the duration (seconds) of facial mimics was significant statistically in favor of group which received musical intervention on the five moments of data collect. The crying had more presence in antisepsis, puncture, squeezing/blood aspiration on MG1, CG1 and CG2, as well as in compression, on CG1 and CG2. On PPM1 (initial), on MG1, and in other moments, on MG2, the newborns showed higher absence of crying (Pearson Qui-Square Test), with p<0.05.

Conclusion:

Despite its small sample size, Music Group 2 showed better results to the effect obtained in music administration when compared with others groups of the study. There was difference on newborn´s behavioral responses of pain submitted to music intervention before, during and after venipuncture for blood collection.

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