The Effect of Kangaroo Care on Physiologic Responses to Pain of an Intramuscular Injection in Neonates

Objective: Pain in neonates can be associated with various risks. So, it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but nonpharmacologic interventions like Kangaroo Care (KC) is found to be effective. The objective of this study was to assess the efficacy of KC on physiologic responses to the pain of an intramuscular injection of vitamin K in term neonates.
Material & Methods: One hundred healthy term neonates were enrolled for this study during 2 months. The inclusion criteria were gestational age 37-42 weeks, normal vaginal delivery, birth weight 2500-4000 gr, age more than 2 hours and Apgar score more than 7 at 1 minute. They were randomly assigned to intervention and control groups. In the intervention group, the neonate was held in KC for 10 minutes before the injection until 3 minutes after injection. In the control group, the neonate was in the prone position in the isolette. The primary outcome measures were heart rate and blood oxygen saturation rate before, during and 3 minutes after injection.
Findings: The heart rate during and 3 minutes after injection for neonates given KC were significantly lower than for neonates in control group (P<0.001). The blood oxygen saturation rate during and 3 minutes after injection for neonates given KC were significantly higher than for neonates in control group (P<0.001).
Conclusion: KC given before injection seems to effectively decrease pain from injection. It is a simple, safe and effective analgesic and should be considered for minor invasive procedures in term neonates.

Keywords
Term neonates, Intramuscular injection, Kangaroo Care, Physiologic responses, Pain