Original Article Oral Glucose and Listening to Lullaby to Decrease Pain in Preterm Infants Supported with NCPAP: A Randomized Controlled Trial Kadir S ¸ erafettin Tekgündüz, MD * , Sevinç Polat, PhD, RN y , Ays ¸ e Gürol, PhD, RN z , Serap Ejder Apay, PhD x * Atatürk University, Faculty of Medicine, Division of Neonatology, Erzurum, Turkey y Department of Pediatric Nursing, Bozok University, School of Health, Yozgat, Turkey z Atatürk University, Health Services Vocational School, Erzurum, Turkey x Atatürk University, Faculty of Health Science, Erzurum, Turkey article info Article history: Received 13 October 2016 Received in revised form 18 February 2018 Accepted 4 April 2018 abstract Preterm infants spend the early days of their lives in neonatal intensive care units, where they undergo many minor painful procedures. There are many nonpharmacologic methods that can effectively reduce the pain response of neonates who undergo routine procedures. This study aimed to investigate whether oral glucose and listening to lullabies could bring pain relief during the removal and reinsertion of the tracheal tube and also oronasopharyngeal suctioning in premature infants to whom nasal continuous positive airway pressure was applied. A double-blind, randomized controlled trial. This study was con- ducted in the neonatal intensive care unit in the tertiary setting between November 2012 and September 2013. A total of 106 preterm infants were divided into three groups, including 37 infants in the control group, 35 infants in the lullaby group, and 34 infants in the glucose group. All preterm infants were randomly assigned to either the intervention groups or the control group. Pain responses were assessed using the Neonatal Infant Pain Scale and the Premature Infant Pain Profile. An assessment of the pain severity of the preterm infants after the intervention indicated that the preterm infants in the lullaby and glucose groups had lower pain, whereas the preterm infants in the control group experienced more pain (p < .05). The findings suggest that pain could be reduced significantly in preterm infants after the suggested intervention, although further studies are required to identify the benefits of lullabies or glucose in infants during other painful procedures. © 2018 by the American Society for Pain Management Nursing Preterm infants spend the early days of their lives in the neonatal intensive care unit (NICU) (Ancora et al., 2013), where they are subjected to approximately 50 to 150 potentially painful procedures every day (Morais et al., 2016), totaling around 750 procedures (Page, 2004) throughout the period of hospitalization in the NICU. The most common procedures in clinical nursing practice are intubation, aspiration of the tracheal tube, collection of samples by arterial puncture, and venous access (Morais et al., 2016), although this may vary depending on the clinical status of the infant and the length of hospitalization (Morais et al., 2016; Standley & Swedberg, 2011). One such painful procedure that is often required in preterm infants is nasal continuous positive airway pressure (NCPAP) (SUPPORT Study Group, 2010; Weiner & Zaichkin, 2016), which is associated with complications as nasal trauma, pain, gastric distention, and obstruction, imposing more burdens on health care team and resulting in overall perceived patient discomfort (Abdel- Hady, Shouman & Aly, 2011; Campbell, Shah, Shah, & Kelly, 2006; Shoemaker, Pierce, Yoder, & DiGeronimo, 2007). Changing the nasal cannula is one of the most common nursing procedures in preterm infants who are supported with NCPAP (Cignacco et al., 2008). The most common painful procedures include endotra- cheal and nasopharyngeal suctioning (Simons et al., 2003). Several studies have reported that the use of CPAP alone reduces the need for surfactants in premature infants (SUPPORT Study Group, 2010; Weiner & Zaichkin, 2016). Manipulation of the CPAP prongs (insertion/reinsertion) is the most prevalent procedure, accounting for 24.3% of the total 27 documented procedures. It has been reported that in preterm infants the removal and insertion of CPAP prongs is a standard procedure after each change of the Address correspondence to Ays ¸ e Gürol, Ph.D., R.N., Ataturk University Health Services, Vocational School, Erzurum 25040, Turkey. E-mail address: ayseparlak42@gmail.com (A. Gürol). Contents lists available at ScienceDirect Pain Management Nursing journal homepage: www.painmanagementnursing.org https://doi.org/10.1016/j.pmn.2018.04.008 1524-9042/© 2018 by the American Society for Pain Management Nursing Pain Management Nursing xxx (xxxx) xxx Please cite this article as: Tekgündüz, K. S ¸ et al., Oral Glucose and Listening to Lullaby to Decrease Pain in Preterm Infants Supported with NCPAP: A Randomized Controlled Trial, Pain Management Nursing, https://doi.org/10.1016/j.pmn.2018.04.008