Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200021
Brazilian Journal of Pain
Original Article

Evaluation of pain in vaginal and caesarean section birth newborns before and after intramuscular injection

Avaliação da dor em recém-nascidos de parto vaginal e cesariana antes e após injeção intramuscular

Esther Angélica Luiz Ferreira; Damaris Souza Nassif; Matheus Jordão Danza Silva; Silvia Maria de Macedo Barbosa; Norma Sueli Pinheiro Módolo; Guilherme Antônio Moreira Barros

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Abstract

BACKGROUND AND OBJECTIVES: It is already known that the painful experiences to which the newborn is subjected may be related to future reactions and differences in the behavioral response to pain in newborns from different birth routes. This study aimed to evaluate the response to pain in infants born by cesarean section and vaginal delivery routes.

METHODS: This is a prospective cohort study. Newborns born at full term were allocated into two groups: cesarean section and vaginal delivery. The intramuscular vitamin K injection was performed as an acute pain stimulus because it is a routine injection at birth. The newborns were evaluated for pain on two scales, a one-dimensional, the Neonatal Facial Coding System, and a multidimensional, the COMFORT Behavior Scale (Comfort b), in addition to heart rate counting, moments before, immediately after and 10 minutes after the stimuli. Students t-test was used for statistical analyzes, and the level of significance was 5%.

RESULTS: Eighty-three children were evaluated. The pain intensity assessed by both scales before the pain stimulus was higher in the cesarean section group, but not statistically significant. Heart rate values after the stimulus showed a statistically significant difference (p<0.05), higher in the cesarean section group than in the vaginal delivery.

CONCLUSION: The results did not suggest that there are differences in the perception of pain among newborns born vaginally and cesarean section.

Keywords

Acute pain, Cesarean section, Newborn, Obstetric delivery

Resumo

JUSTIFICATIVA E OBJETIVOS: As experiências dolorosas as quais o recém-nascido é submetido podem ter relação com reações futuras e que existem diferenças no comportamento de resposta à dor nos recém-nascidos oriundos de diferentes vias de parto. O estudo teve como objetivo avaliar a resposta à dor em bebês nascidos por cesariana e parto vaginal.

MÉTODOS: Estudo coorte prospectivo que incluiu recém-nascidos nascidos a termo, de cesariana e parto vaginal. Utilizou-se, como estímulo doloroso agudo, a injeção intramuscular de vitamina K rotineira ao nascimento. Os recém-nascidos foram avaliados quanto à dor pela escala unidimensional Neonatal Facial Coding System e pela multidimensional COMFORT Behavior Scale (Comfort b), além da frequência cardíaca nos momentos antes, imediatamente após e 10 minutos após o estímulo. Foi utilizado teste t de Student para a análise estatística com significância de 5%.

RESULTADOS: Foram avaliadas 83 crianças. A intensidade da dor avaliada por ambas as escalas antes do estímulo doloroso foi maior no grupo de recém-nascidos de cesariana, porém não foi estatisticamente significativa. Os valores da frequência cardíaca após o estímulo mostraram diferença estatisticamente significativa (p<0,05) maiores no grupo cesariana que no parto vaginal.

CONCLUSÃO: Os dados obtidos não evidenciaram diferenças na percepção da dor entre recém-nascidos de parto vaginal e cesariana.

Palavras-chave

Cesariana, Dor aguda, Parto obstétrico, Recém-nascido

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Submitted date:
11/06/2019

Accepted date:
03/05/2020

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