Swaddling Effect on Pain of Nasogastric Tube Insertion in Premature Infants: A Crossover Design, Randomized Clinical Trial

Premature infants experience painful procedures during care and treatment. Nurses should reduce short and long-term effects of pain caused by diagnostic and therapeutic procedures. The aim of this study was to determine the swaddling effect on pain of nasogastric tube insertion in preterm infants. It was a cross-over randomized clinical trial. Thirty eight premature infants were first recruited by convenience sampling and then were randomly allocated into two groups. The first group of infants, received nasogastric tube insertion, first by routine method and then by swaddling method. Arrangement of the nasogastric tube insertion was reversed in the second group of infants. In both groups pain was measured using PIPP (Premature Infant Pain Profile) in two-minute intervals before, during and five minutes after nasogastric tube insertion. Data was analyzed by ANOVA for quantitative variables and Repeated Measurement test to examine trend of changes using SPSS-PC (v.13). P- Value less than 0.05 was considered as statistically significant. The results showed that swaddling has reduced the pain response during and five minutes after nasogastric tube insertion respectively (p<0.001, p=0.05). Since the findings indicated swaddling has reduced nasogastric insertion induced pain, it is recommended that nurses apply this method as an effective intervention to reduce neonatal pain.