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Stadler, J.
Laser acupuncture compared with oral glucose administration for pain prevention in healthy term neonates undergoing routine heel sticks/lance.
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2022. pp. 112 [OPEN ACCESS]


Authors Med Uni Graz:
Avian Alexander
Raith Wolfgang
Urlesberger Berndt

Introduction: Non-pharmacological pain management in neonates is an important research field. Oral sweet solutions are actual standard of care for neonatal pain prevention in minor painful interventions. Recent literature suggests that acupuncture at Large Intestine 4 (LI4) produce analgesic effects in clinical and experimental studies. Therefore, this study aims to investigate, if laser acupuncture at LI4 will reduce pain associated with minor painful procedures non-inferior to orally administrated glucose solution. Methods: We included 96 healthy term neonates receiving heel lance on 3rd day of life for metabolic screening. They were randomly assigned to either laser acupuncture group (AG) or oral glucose solution group (GG). Laser acupuncture was applied with Soft-laser 10mW at LI4 for 1 min both sides. GG received 30% glucose solution orally 2 min prior to heel lance. Main outcome parameter pain was evaluated using PIPP (Premature Infant Pain Scale) observer-blinded. Secondary parameters were crying duration or heart rate changes (HR). Statistical analysis was performed in non- inferiority concept (margin: <1). Results: PIPP scores showed a Median (IQR) of AG 12 (10 -14) vs. GG 12 (9 – 14) [p= 0.981, 95%CI: -1.000006 – 1.000059]. Secondary outcomes showed equal crying times between groups [AG 102.0 sec (58.0 – 159.0) vs. GG 92.5 sec (58.5 – 173.5) p=0.890]. HR was significantly different between groups after intervention (p=0.048) and after heel lance (p=0.015). Difference between groups resulted due to an increased HR in GG and decrease in AG. Discussion: We found equal median pain scores between groups. Nevertheless, due to high variability within the studied sample, laser acupuncture could not be declared non-inferior to glucose solution regarding main outcome. However, we found positive effects on crying time and heart rate in AG. Decreased HR in AG can be interpreted as a sign of relaxation, whereas the increased HR in GG was probably caused by the glucose solution and the non-nutritive sucking. Conclusion: This study indicates clinical relevance of laser acupuncture at LI4 for pain relief in neonates. The present data should be taken into account for further laser acupuncture studies.

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