Objectives: : During hospitalization in the neonatal intensive care unit, preterm infants are vulnerable against a wide range of stress and stimulation, therefore they need the effective pain management during and after the painful and frequent painful interventions.
Design: 4 groups, double blind randomized control trial.
Setting and conduct: Neonatal Intensive Care Unit (NICU) of Shahid Akbar Abadi educational & treatment center.
Participants: 120 healthy preterm infants with gestational age32-36 weeks; Birth weight over 1500 gr; Apgar score at 1 and 5 min after birth ≥ 7; postnatal age 48 hours or more; Oral feeding, Receiving no sedative drugs during the last 48 hours, will randomly assigned to three experimental groups and control group. Observation of any abnormal physiologic responses; touch and medical or nursing interventions during study; also blood sampling for more than one location; and except of radial and brachial areas, infant will be excluded.
Intervention: Two min before blood sampling, in the sucrose group 0.5 ml oral sucrose solution 24% will be administered with a syringe on the anterior portion of the tongue, also, braham`s lullaby will be played for 10 minutes at 40-50 db via earphone in the music group. In the combination group, simultaneously 0.5 ml sucrose 24% will be administered and lullaby music will be played for infants. Physiologic responses and facial changes will be recorded simultaneously with using two video cameras during different phases. For blinding, in control group, 0.5 ml sterile water will be administered with a syringe on the anterior portion of the tongue, the earphone will be used for all groups , meanwhile a research assistant will analyze the films.
Main outcome: Pain score will be calculated before blood sampling (base line), 30 seconds after the start of the blood sampling, 30 seconds and 10th min post blood sampling by using the Premature Infant Pain Profile (PIPP).