Ignite Creation Date:
2024-05-05 @ 9:41 PM
Last Modification Date:
2024-10-26 @ 10:08 AM
Study NCT ID:
NCT00949104
Status:
COMPLETED
Last Update Posted:
2009-07-30
First Post:
2009-07-29
Brief Title:
Role of Oral Sucrose in Reducing the Pain to Orogastric Tube Insertion in Preterm Neonates
Sponsor:
Lady Hardinge Medical College
Organization:
Lady Hardinge Medical College
Study Overview
Official Title:
A Study to Assess the Role of Oral Sucrose in Reducing the Pain to Orogastric Tube Insertion in Preterm Neonates
Status:
COMPLETED
Status Verified Date:
2009-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
RESEARCH HYPOTHESIS Orally administered sucrose 2 minutes prior to the procedure of OGT insertion reduces pain associated with the procedure
AIMS AND OBJECTIVES
To study the effect of 24 oral sucrose on decreasing the painful response to orogastric tube insertion
AIMS AND OBJECTIVES
To study the effect of 24 oral sucrose on decreasing the painful response to orogastric tube insertion
Detailed Description:
MATERIAL METHODS
PARTICPANTS
INCLUSION CRITERIA The enrolled participants must fulfill the following inclusion criteria
All pre-terms 37 weeks of gestational age
Within the first 7 days postnatal days 168 hours
Clinically stable from respiratory hemodynamic and metabolic point of view
Who have not received any painful stimulus at least 30 minutes prior to the intervention
Requiring routine orogastric tube insertion within the first 7 days of life
Only the first attempt at putting OGT in controlled NICU environment will be considered
EXCLUSION CRITERIA The neonates with the following characteristics will be excluded from the study
Neonates requiring ventilatory support
Neonates requiring oxygen supplementation
Having any facial congenital anomalies
Having any neurological impairment
Receiving opiates or born to mothers receiving opiates
New born babies to whom muscle relaxants sedatives and analgesics have been administered
With grade 3 and 4 IVH
With major congenital anomalies
Any history of birth trauma especially involving face or scalp including cephalhematoma subgaleal bleed
Face presentation
INTERVENTIONS
There will be two groups in the study group A group B The enrolled neonates will be administered either a sterile solution of 24 sucrose or double distilled water orally These solutions will be prepared under all sterile precautions by the laboratory staff unrelated to the study and packed in 2 ml sterile syringes further covered with opaque sealed envelopes bearing serially numbered patient codes The composition of these packets would be decided by a senior consultant in the department of pharmacology who would have the access to the randomization sequence and would be uninvolved in the present study Fresh solutions will be prepared daily and unused solutions will be discarded at the end of the day to be replaced with identically numbered solutions from the laboratory All study solutions will be stored in the refrigerator at 2-8 0C until they are used
The patients will be enrolled into the study only after an informed written consent has been obtained from either of the parent caregiver 2 minutes prior to procedure 1 ml of the solution marked with patientss serial number will be administered orally to the patient by a nurse using the syringe The procedure would involve putting a 5-6 Fr OGT in the neonate which will be done by a group of 8-10 nurses who have been specially trained in this procedure This insertion of OGT will be done 2 min post administration of test solution by a nurse who will be blinded to the contents of the solution
The whole procedure beginning 2 minutes before the OGT insertion and continuing till 4 minutes after it is inserted will be video recorded on a fixed camera focusing on the face of the patient Neonate will be monitored using a non invasive vital signs monitor to monitor his heart rate and SpO2 changes during the entire procedure and for 2 minutes post procedure The highest heart rate and lowest SpO2 obtained during the procedure till 2 minutes post procedure will be recorded The research candidate will evaluate the pain response to the procedure according to the PIPP scale at time tpre-procedure tintra-proceduretpost 30 sec tpost 1min tpost 2 min wherein t denotes the time at which tube is inserted into the oral cavity The research candidate will also monitor the time taken in the OGT insertion using a stopwatch The neonatal nurse putting the OGT will rate the procedure as easy difficult or very difficult
OUTCOMES
PRIMARY OUTCOME Painful response as assessed by the PIPP scale SECONDARY OUTCOME Maximum heart rate and minimum oxygen saturation recorded during the procedure
SAMPLE SIZE CALCULATIONThe sample size was calculated based on the assumption that there would be a decrease of at least 20 in the pain scores in the study population with the intervention and using a alpha error of 005 and a power of 90 the sample size was calculated to be 55 each in both the groups ie a total of 110 neonates
RANDOMISATIONBlock Randomisation using computer generated random sequences with a block size of 4 each
SEQUENCE GENERATION
Block randomization using computer generated random sequences will be used
ALLOCATION CONCEALMENT
This will be done by the pharmacy who will pack the sucrose and the double distilled water controlplacebo into identical containers and opaque sealed envelopes sequentially labeled according to randomization code
IMPLEMENTATION
Randomization sequence will be generated by a senior consultant in the department of pharmacology The participants will be enrolled for the study by the candidate according to the serial number as the candidate will be blinded
BLINDING
The participants the research candidatethe nursing staff administering the intervention as well as the investigators assessing the painful response will be blinded to the group assignment
STATISTICAL METHODS Descriptive statistics will be calculatedBetween groups comparison of continuous variables will be done with the help of t test for parametric data and by Mann Whitney test for non parametric dataThe proportion and frequencies will be calculated using the chi square test
PARTICPANTS
INCLUSION CRITERIA The enrolled participants must fulfill the following inclusion criteria
All pre-terms 37 weeks of gestational age
Within the first 7 days postnatal days 168 hours
Clinically stable from respiratory hemodynamic and metabolic point of view
Who have not received any painful stimulus at least 30 minutes prior to the intervention
Requiring routine orogastric tube insertion within the first 7 days of life
Only the first attempt at putting OGT in controlled NICU environment will be considered
EXCLUSION CRITERIA The neonates with the following characteristics will be excluded from the study
Neonates requiring ventilatory support
Neonates requiring oxygen supplementation
Having any facial congenital anomalies
Having any neurological impairment
Receiving opiates or born to mothers receiving opiates
New born babies to whom muscle relaxants sedatives and analgesics have been administered
With grade 3 and 4 IVH
With major congenital anomalies
Any history of birth trauma especially involving face or scalp including cephalhematoma subgaleal bleed
Face presentation
INTERVENTIONS
There will be two groups in the study group A group B The enrolled neonates will be administered either a sterile solution of 24 sucrose or double distilled water orally These solutions will be prepared under all sterile precautions by the laboratory staff unrelated to the study and packed in 2 ml sterile syringes further covered with opaque sealed envelopes bearing serially numbered patient codes The composition of these packets would be decided by a senior consultant in the department of pharmacology who would have the access to the randomization sequence and would be uninvolved in the present study Fresh solutions will be prepared daily and unused solutions will be discarded at the end of the day to be replaced with identically numbered solutions from the laboratory All study solutions will be stored in the refrigerator at 2-8 0C until they are used
The patients will be enrolled into the study only after an informed written consent has been obtained from either of the parent caregiver 2 minutes prior to procedure 1 ml of the solution marked with patientss serial number will be administered orally to the patient by a nurse using the syringe The procedure would involve putting a 5-6 Fr OGT in the neonate which will be done by a group of 8-10 nurses who have been specially trained in this procedure This insertion of OGT will be done 2 min post administration of test solution by a nurse who will be blinded to the contents of the solution
The whole procedure beginning 2 minutes before the OGT insertion and continuing till 4 minutes after it is inserted will be video recorded on a fixed camera focusing on the face of the patient Neonate will be monitored using a non invasive vital signs monitor to monitor his heart rate and SpO2 changes during the entire procedure and for 2 minutes post procedure The highest heart rate and lowest SpO2 obtained during the procedure till 2 minutes post procedure will be recorded The research candidate will evaluate the pain response to the procedure according to the PIPP scale at time tpre-procedure tintra-proceduretpost 30 sec tpost 1min tpost 2 min wherein t denotes the time at which tube is inserted into the oral cavity The research candidate will also monitor the time taken in the OGT insertion using a stopwatch The neonatal nurse putting the OGT will rate the procedure as easy difficult or very difficult
OUTCOMES
PRIMARY OUTCOME Painful response as assessed by the PIPP scale SECONDARY OUTCOME Maximum heart rate and minimum oxygen saturation recorded during the procedure
SAMPLE SIZE CALCULATIONThe sample size was calculated based on the assumption that there would be a decrease of at least 20 in the pain scores in the study population with the intervention and using a alpha error of 005 and a power of 90 the sample size was calculated to be 55 each in both the groups ie a total of 110 neonates
RANDOMISATIONBlock Randomisation using computer generated random sequences with a block size of 4 each
SEQUENCE GENERATION
Block randomization using computer generated random sequences will be used
ALLOCATION CONCEALMENT
This will be done by the pharmacy who will pack the sucrose and the double distilled water controlplacebo into identical containers and opaque sealed envelopes sequentially labeled according to randomization code
IMPLEMENTATION
Randomization sequence will be generated by a senior consultant in the department of pharmacology The participants will be enrolled for the study by the candidate according to the serial number as the candidate will be blinded
BLINDING
The participants the research candidatethe nursing staff administering the intervention as well as the investigators assessing the painful response will be blinded to the group assignment
STATISTICAL METHODS Descriptive statistics will be calculatedBetween groups comparison of continuous variables will be done with the help of t test for parametric data and by Mann Whitney test for non parametric dataThe proportion and frequencies will be calculated using the chi square test
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None