Efficacy and Safety of Single Low Dose Intravenous Fentanyl in Pain Reduction of Lumbar Puncture in Near Term Neonates by A Randomized Clinical Trial

How to Cite This Article: Fallah R, Habibian S, Noori-Shadkam M. Efficacy and Safety of Single Low Dose Intravenous Fentanyl in Pain Reduction of Lumbar Puncture in Near Term Neonates by A Randomized Clinical Trial. Iran J Child Neurol. Spring 2016; 10(2):60-66.AbstractObjectiveReduction of pain of invasive procedures in neonates can prevent pain side effects. The purpose of present study was to evaluate the efficacy and safety of a single low dose of intravenous fentanyl in reducing of lumbar puncture (LP) pain in neonates.Materials & MethodsIn this randomized clinical trial, registered with code number of 2014022616761N150, admitted neonates to Shahid Sadoughi Hospital, Yazd, Iran from August-April 2012 (45 cases) were randomly assigned into two groups to receive 2 μg/kg of intravenous fentanyl or 0.2 milliliter of normal saline, two min before LP. Primary outcome was success rate in reducing of pain during needle insertion to skin (pain score of less than three). Secondary outcomes were clinical side effects and serious adverse events.ResultsForty-five neonates including 23 girls and 22 boys were evaluated. Pain reduction was obtained in 39.1% (9 of 23 neonates) of fentanyl group and in 4.5% (one of 22 neonates) of control group. Means of pulse rate (136.41± 9.16 vs. 148.9± 8.99) and pain score during needle insertion (3.41±1.31 vs. 5.8±1.12) were lower in fentanyl group. No severe adverse effects were seen in both groups. Side effects such as vomiting [9% (N=2) in control and 4.3% (N=1) in fentanyle group] and mild transient decrease in oxygen saturation in 8.7% (N=2) of fentanyle group were seen. Safety in two groups was not statistically different.ConclusionIntravenous fentanyl might be considered as a safe and effective analgesic drug in LP in neonates.ReferencesLehman RL, Schor NF. Special Diagnostic Procedures. In: Kliegman RM, Stanton BF, Schor NF, St. GemeJW, Behrman RE. Nelson Textbook of Pediatrics. 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Perceived Benefits and Barriers of Mothers with Premature Infant to Kangaroo Mother Care

Background Kangaroo Mother Care (KMC) is an easy and emotional care that can reduce the mortality and morbidity in premature infants, but often the relationship between mother and her newborn is delayed due to some barriers. The aim of this study was to investigate perceived benefits and barriers of mothers in this regard. Materials and Methods: In this descriptive cross-sectional study, 121 mothers with premature infants admitted to the Neonatal Intensive Care Unit (NICU) of Yazd Shahid Sadoughi Hospital, Iran, studied using convenience sampling method in 2018. Data gathering accomplished by interviewing mothers using researcher-made questionnaire included baseline characteristics of parents and their infant and items measuring perceived benefits and barriers of mothers to KMC. The data were analyzed using SPSS software version 22.0 Results: Strengthening of the emotional relationship between mother and infant and a greater sense of confidence were the main perceived benefits of mothers. Not being in good physical and mental condition, lack of relevant knowledge and fear of performing KMC were the most important perceived barriers of mothers to KMC. The perceived benefits differed only in mother's ethnicity and father's occupation (P0.05). Conclusion According to the results though the high perceived benefits of mothers in performing KMC, it seems that planning for improving mothers mental condition, providing mothers with necessary knowledge and reducing fear of caring can effectively promote doing KMC by mothers

Household food insecurity is associated with abdominal but not general obesity among Iranian children

Abstract Background Childhood obesity is increasing all over the world. Food insecurity is mentioned as a possible risk factor; however, previous studies have led to inconsistent results in different societies while data are lacking for the Middle East. We aimed to investigate the relationship between food insecurity and general or abdominal obesity in Iranian children in a cross-sectional study. Methods Anthropometric data including height, weight, and waist circumference were measured by trained nutritionists. General and abdominal obesity were defined based on world health organization (WHO) and Iranian reference curves for age and gender, respectively. Radimer/Cornell food security questionnaire was filled by parents. Data about the physical activity of participants, family socio-economic status, parental obesity and data about perinatal period were also gathered using self-administered questionnaires. Logistic regression was incorporated to investigate the association between food insecurity and obesity in crude and multi-variable adjusted models. Results A total of 587 children aged 9.30 ± 1.49 years had complete data for analysis. Food insecurity at household level was significantly associated with abdominal obesity (odds ratio (OR) = 1.54; confidence interval (CI):1.01–2.34, p <0.05) and the relationship remained significant after adjusting for all potential confounding variables (OR = 2.02; CI:1.01–4.03, p <0.05). Food insecurity was associated with general obesity neither in crude analysis and multi-variable adjusted models. Conclusions The slight levels of food insecurity might increase the likelihood of abdominal obesity in Iranian children and macroeconomic policies to improve the food security are necessary. Large-scale prospective studies, particularly in the Middle East, are highly recommended to confirm our results