The management of the pain is a constant care concern in neonatal and maternity units. Many studies show an interest in the use of sugar solutions to reduce nociception during painful events in infants. However, these studies are based mainly on behavioral observation of the newborn but intrinsic mechanisms of analgesic power are not clearly understood for sucrose solutions. Our hypothesis is that the analgesic mechanism of sucrose solutions in infants involves a subcortical reactivity notably by action via the brain stem. To explore the intensity of pain and evaluate the subcortical activity, we will use 1) the analysis of heart rate variability (frequency indices whose HFnu) as a peripheral witness of subcortical functioning of the autonomic nervous system 2) electroacoustic analysis of the intensity of crying baby, 3) a composite pain score (DAN score).
The investigators want to show that the short term autonomic nervous system (ANS) response, after a nociceptive action in the new-born in maternity depends on whether it is preceded by non-nutritive sucking and / or sucrose administration.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
180
CHU de Saint-Etienne
Saint-Etienne, France
High frequency normalized index (HFnu)
It is a reflect of the RR short term heart rate variability (HRV) in the frequency domain. It is measured with a ECG Holter monitor.
Time frame: From 15 min before the painful care to 15 min after.
Low frequency (LF and LFnu),
It is another index of RR heart rate variability (HRV) measured with a ECG Holter monitor.
Time frame: From 15 min before the painful care to 15 min after.
Scale of hetero-assessment of pain (DAN)
The DAN scale is specific to acute pain of the newborn
Time frame: 15 minutes after the painful care
Electro acoustical characteristic of crying newborn : Duration
An acoustic recording of children's tears will be conducted in parallel with a microphone and dedicated software to study the properties of crying caused by the puncture. Continuous recording begins at least fifteen minutes before the procedure and is kept up to fifteen minutes after the invasive procedure. The child must be quiet. It will be placed in its cocoon to limit environmental stress
Time frame: From 15 min before the painful care to 15 min after.
Frequency domain
It is another index of RR heart rate variability (HRV) measured with a ECG Holter monitor.
Time frame: From 15 min before the painful care to 15 min after.
The time domain (SDNN, SDANN, pNN50).
It is another index of RR heart rate variability (HRV) measured with a ECG Holter monitor.
Time frame: From 15 min before the painful care to 15 min after.
LF / HF ratio
It is another index of RR heart rate variability (HRV) measured with a ECG Holter monitor.
Time frame: From 15 min before the painful care to 15 min after.
Electro acoustical characteristic of crying newborn : Frequency
An acoustic recording of children's tears will be conducted in parallel with a microphone and dedicated software to study the properties of crying caused by the puncture. Continuous recording begins at least fifteen minutes before the procedure and is kept up to fifteen minutes after the invasive procedure. The child must be quiet. It will be placed in its cocoon to limit environmental stress
Time frame: From 15 min before the painful care to 15 min after.
Electro acoustical characteristic of crying newborn : Frequency variations
An acoustic recording of children's tears will be conducted in parallel with a microphone and dedicated software to study the properties of crying caused by the puncture. Continuous recording begins at least fifteen minutes before the procedure and is kept up to fifteen minutes after the invasive procedure. The child must be quiet. It will be placed in its cocoon to limit environmental stress
Time frame: From 15 min before the painful care to 15 min after.
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