{"title":"The effect of the ShotBlocker® and breastfeeding on pain and comfort level during heel lance procedure in newborns: randomized controlled trial","authors":"Canan Dinç , Gülçin Özalp Gerçeker , Oğuzhan Kalkanli","doi":"10.1016/j.iccn.2025.104164","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Newborns are subjected to painful attempts in the early days of their lives due to medical requirements. Breastfeeding and innovative devices such as ShotBlocker® are used to alleviate pain.</div></div><div><h3>Objectives</h3><div>This study was planned to evaluate the effect of non-pharmacological methods on newborns’ pain and comfort level during the heel lance procedure in newborns.</div></div><div><h3>Design</h3><div>The study was a single-center, randomized controlled trial.</div></div><div><h3>Setting</h3><div>This study was conducted in the first-level neonatal intensive care unit between August 2021 and September 2022.</div></div><div><h3>Methods</h3><div>Ninety-six newborns were included in this study based on inclusion criteria. The newborns were randomly assigned to four groups: (a) breastfeeding, (b) ShotBlocker®, (c) breastfeeding + ShotBlocker®, and (d) standard care. Pain and comfort levels of newborns were evaluated according to the Neonatal Infant Pain Scale and the Newborn Comfort Behavior Scale before, during, and after the heel lance procedure. Crying time, heart rate, and oxygen saturation were recorded.</div></div><div><h3>Results</h3><div>The difference between the groups in terms of average crying time (p = 0.001) and comfort levels after the procedure (p = 0.001) was statistically significant. There was no difference in pain during and after the procedure. As a result of multiple analyses of variance in repeated measurements, a difference was found in comfort scores in terms of group, time, and group-time interaction (p < 0.05).</div></div><div><h3>Conclusion</h3><div>The breastfeeding + ShotBlocker® group had the lowest mean crying time. There was no difference in procedure-related pain scores between the groups. The most comfortable groups after heel lance were the breastfeeding and breastfeeding + ShotBlocker® groups.</div></div><div><h3>Implication for clinical practice</h3><div>Breastfeeding, currently the gold non-pharmacological standard, increased comfort levels during the heel lance procedure. The breastfeeding + ShotBlocker® had a significant reduction in crying time and a significantly greater post-procedural comfort level (Clinical Trials number: NCT05246787).</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104164"},"PeriodicalIF":4.7000,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339725002265","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Newborns are subjected to painful attempts in the early days of their lives due to medical requirements. Breastfeeding and innovative devices such as ShotBlocker® are used to alleviate pain.
Objectives
This study was planned to evaluate the effect of non-pharmacological methods on newborns’ pain and comfort level during the heel lance procedure in newborns.
Design
The study was a single-center, randomized controlled trial.
Setting
This study was conducted in the first-level neonatal intensive care unit between August 2021 and September 2022.
Methods
Ninety-six newborns were included in this study based on inclusion criteria. The newborns were randomly assigned to four groups: (a) breastfeeding, (b) ShotBlocker®, (c) breastfeeding + ShotBlocker®, and (d) standard care. Pain and comfort levels of newborns were evaluated according to the Neonatal Infant Pain Scale and the Newborn Comfort Behavior Scale before, during, and after the heel lance procedure. Crying time, heart rate, and oxygen saturation were recorded.
Results
The difference between the groups in terms of average crying time (p = 0.001) and comfort levels after the procedure (p = 0.001) was statistically significant. There was no difference in pain during and after the procedure. As a result of multiple analyses of variance in repeated measurements, a difference was found in comfort scores in terms of group, time, and group-time interaction (p < 0.05).
Conclusion
The breastfeeding + ShotBlocker® group had the lowest mean crying time. There was no difference in procedure-related pain scores between the groups. The most comfortable groups after heel lance were the breastfeeding and breastfeeding + ShotBlocker® groups.
Implication for clinical practice
Breastfeeding, currently the gold non-pharmacological standard, increased comfort levels during the heel lance procedure. The breastfeeding + ShotBlocker® had a significant reduction in crying time and a significantly greater post-procedural comfort level (Clinical Trials number: NCT05246787).
期刊介绍:
The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.