The effect of the four-handed method on the pain caused by gastric tube insertion in premature infants: A randomized clinical trial

The present study aims to determine the effect of the four-handed method on the pain caused by gastric tube insertion in premature infants. This study, conducted from ۲۰۲۲ to ۲۰۲۳, involved ۸۰ premature infants selected using a convenience sampling method and randomly assigned to two groups of ۴۰ by coin toss. The control group underwent orogastric tube insertion using the routine two-handed method, while the intervention group received the procedure using the four-handed method. The infants' pain levels were assessed using the Premature Infant Pain Profile (PIPP) before, during, and ۳۰ seconds after the gastric tube insertion. The researcher documented facial expressions before, during, and after the procedure while the monitor recorded physiological data concurrently. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version ۱۶, employing independent t-tests, analysis of covariance (ANCOVA), and chi-square tests. Before the intervention, the independent t-test revealed no statistically significant difference in pain scores between the two groups (P=۰.۴۴۴). During the intervention, the analysis of covariance similarly indicated no statistically significant difference in pain levels between the groups (P=۰.۰۹۹). However, following the intervention, the analysis of covariance identified a statistically significant difference in pain scores between the two groups (P=۰.۰۱۵). The four-handed method appears to reduce pain following Orogastric tube insertion; however, it does not seem to significantly affect pain during insertion. Consequently, it is recommended that further research be conducted in this area to explore and confirm these findings.

Keywords:

Four-handed Method , Pain , Premature Infant , Gastric Tube , Neonatal Intensive Care Unit