Comparison of the Effect of Pressure Massage of Hegu Point with Kunlun Taixi Points on Pain of Intramuscular Injection in Premature Newborns: A Randomized Clinical Trial

Atefeh Jadidi, Fatemeh Ghasemi, Rasool Mohammadi, Fatemeh Janani, Fatemeh Valizadeh, Kimia Karami

Abstract


Background: Performing painful procedures in premature newborns are prevalent. This study compared the effect of the pressure massage of Hegu point with Kunlun‑Taixi points on the pain of intramuscular injection in premature newborns.

Materials and Methods: This triple‑blind, parallel, clinical trial was conducted in the Neonatal Intensive Care Unit (NICU) of Shahid Rahimi Hospital, Khorramabad, Iran. Participants included 100 premature newborns randomly assigned to four groups (n = 25). The intervention groups received a counterclockwise pressure massage of the Hegu or Kunlun‑Taixi points for two minutes. The placebo group received a pressure massage of the tip of the nose. The control group received routine care. The Astrid Lindgren and Lund Children’s Hospital Pain Scale was used to observe pain behaviors before, during, and after intramuscular injection of vitamin K. One‑way Analysis of Variance (ANOVA), repeated measures ANOVA, and Chi‑square tests were used for data analysis.

Results: The mean (Standard Deviation) of pain scores during injection in the Hegu massage, Kunlun‑Taixi massage, control, and placebo groups were 5.92 (1.99), 5.94 (1.75), 6.66 (1.45), and 6.56 (1.61), respectively. Despite the lower pain scores of the intervention groups compared to the control and placebo groups, their difference was not statistically significant (F = 1.32; p = 0.27).

Conclusions: Using pressure massage before intramuscular injection of vitamin K has no significant effect on intramuscular injection pain in premature newborns. It is suggested that future studies of massage be performed for a more extended period, along with other pain relief methods for premature newborns.

 


Keywords


Acupressure, infant, injections, intramuscular, newborn, pain, premature birth

Full Text:

PDF

References


Shen Q, Huang Z, Leng H, Luo X, Zheng X. Efficacy and safety of non pharmacological interventions for neonatal pain: An overview of systematic reviews. BMJ Open 2022;12:e062296.

Campbell Yeo M, Eriksson M, Benoit B. Assessment and management of pain in preterm infants: A practice update. Children (Basel) 2022;9:244.

Pereira FL, Gaspardo CM. Neonatal pain and developmental outcomes in children born preterm: An updated systematic review. Psychol Neurosci 2024;17:1 5.

Cruz M, Fernandes A, Oliveira C. Epidemiology of painful procedures performed in neonates: A systematic review of observational studies. Eur J Pain 2016;20:489 98.

Williams MD, Lascelles BD. Early neonatal pain – A review of clinical and experimental implications on painful conditions later in life. Front Pediatr 2020;8:30.

Weng Y, Zhang J, Chen Z. Effect of non pharmacological interventions on pain in preterm infants in the neonatal intensive care unit: A network meta analysis of randomized controlled trials. BMC Pediatrics 2024;24:9.

Valizadeh F, Ahmadi F, Zarea K. Iranian parents’ supportive umbrella during their children surgery: A qualitative study. Int J Pediatr 2016;4:1545 57.

Yaban ZS. Usage of non pharmacologic methods on postoperative pain management by nurses: Sample of Turkey. Int J Caring Sci 2019;12:529 41.

Rababa M, Al Sabbah S, Hayajneh AA. Nurses’ perceived barriers to and facilitators of pain assessment and management in critical care patients: A systematic review. J Pain Res 2021;14:3475 91.

Chen L, Huang L, Su Y, Lin H, Su B. Effects of combined acupressure and meridian massage on increasing body weight in low birth weight premature infants. Pediatr Crit Care Med 2014;15 (4_suppl):34.

Oğul T, Kurt FY. A nonpharmacological approach on procedural pain management in neonates: Acupressure practice. Adv Health Sci Res 2020;2020:148.

Najafi F, Jaafarpour M, Sayehmiri K, Khajavikhan J. An evaluation of acupressure on the sanyinjiao (SP6) and hugo (LI4) points on the pain severity and length of labor: A systematic review and meta analysis study. Iran J Nurs Midwifery Res 2018;23:1 7.

Carmona Rodríguez MÁ, Martínez Flores S, Morilla Romero de la Osa R, Luque Oliveros M. Effects of acupressure on maternal and neonatal obstetric outcomes during labor: Study protocol. Healthcare (Basel) 2023;11:2111.

Makvandi S, Karimi L, Mahdavian M. A systematic review and meta analysis of the effect of acupressure on relieving the labor pain. Iranian J Nurs Midwifery Res 2020;25:455.

Liangyue D, Yijun G, Shuhui H, Xiaoping J, Yang L, Rufen W. Chinese acupuncture and moxibustion. In: Chaudhury RR, Rafei UM, editors. Traditional medicine in Asia. New Delhi: World Health Organization, Regional Office for South-East Asia; 2001: p. 75-84.

Ghasemi SS, Beyramijam M, Yarahmadi F, Nematifard T, Bahrani SS, Khaleghverdi M. Comparison of the effects of Hugo’s point massage and play on IV Line placement pain in children: A randomized clinical trial. Pain Res Manag 2021;2021:6612175.

Khosravan S, Atayee P, Mazloum Shahri SB, Mojtabavi SJ. Effect of Hugo’s point massage with and without ice on vaccination related pain in infants. Hayat 2018;24:7 19.

Institute of Acupuncture and Moxibustion Standard Meridian Points of Acupuncture: Charts. New Phoenix Intl Llc; 2000.

Abbasoğlu A, Cabıoğlu MT, Tuğcu AU, İnce DA, Tekindal MA, Ecevit A, et al. Acupressure at BL60 and K3 points before heel lancing in preterm infants. Explore 2015;11:363 6.

Özkan TK, Küçükkelepçe DS, Özkan SA. The effects of acupressure and foot massage on pain during heel lancing in neonates: A randomized controlled trial. Complement Ther Med 2019;46:103 8.

Lundqvist P, Kleberg A, Edberg AK, Larsson BA, Hellström Westas L, Norman E. Development and psychometric properties of the Swedish ALPS Neo pain and stress assessment scale for newborn infants. Acta Paediatr 2014;103:833 9.

Pourashoori Z, Hosseini MB, Safaiyan A, Ghorbani F, Arshadi Bostanabad M. The impact of blood sampling site on pain score in preterm infants: A crossover randomized clinical trial. International Journal of Pediatrics -Mashhad. 2018;6:7157-66.

Mirlashari J, Holsti L, Begjani J, Roohipoor R, Kasaeian A, Fakhr AS. Comparison of breast milk and sucrose in neonatal pain relief and coping with stress of rop examination using alps neo. Iran J Neonatol 2021;12:46 55.

Tou SI, Huang CY, Yen HR. Effect of acupoint stimulation on controlling pain from heel lance in neonates: A systematic review and meta analysis of randomized controlled trials. Children (Basel) 2023;10:1024.

Ogul T, Kurt FY. Effect of acupressure on procedural pain before heel lancing in neonates. J Tradit Chin Med 2021;41:331 7.

Kirca AS, Gul DK. Effects of acupressure and shower applied in the delivery on the intensity of labor pain and postpartum comfort. Eur J Obstet Gynecol Reprod Biol 2022;273:98 104.

Stadler J, Raith W, Mileder LP, Schmölzer GM, Urlesberger B. Invasive and non invasive acupuncture techniques for pain management in neonates: A systematic review. Acupunct Med 2019;37:201 10.

Abbasoglu A, Cabioglu MT. Our experience in neonatal acupressure and acupuncture. Open Access Libr 2016;3:1 4.

Daihimfar F, Babamohamadi H, Ghorbani R. A comparison of the effects of acupressure and music on venipuncture pain intensity in children: A randomized controlled clinical trial. Pain Res Manag 2024;2024:2504732.

Moghaddam K, Sadeghi T, Khakshour A, Vakilzadeh AK, Farhat AS. Comparison of the effect of abdominal massage and Hugo point acupressure on infantile colic symptoms. Evid Based Care 2022;11:40 7.


Refbacks

  • There are currently no refbacks.