Pain behavior of children with bilateral idiopathic clubfoot undergoing Ponseti casting and the effect of non-pharmaceutical pain-relieving agents.

Abstract

INTRODUCTION:

This study prospectively investigated the pain response and physiological parameters [heart rate (HR) and oxygen saturation (SpO2)] during sequential casting in bilateral clubfoot. Additionally, it explored the role of non-nutritive sucking and human care contact on the observed responses during casting.

METHODS:

Subjects were allotted to control group (Group A with no intervention) and two intervention groups (Group B: non-nutritive sucking intervention, Group C: human care contact intervention). Neonatal Infant Pain Score (NIPS), heart rate (HR), and oxygen saturation (SpO2) were used to assess the response.

RESULTS:

The three groups matched in age and gender characteristics of the participants. Pain response was noted across all groups. The left foot demonstrated a statistically significant preexisting tachycardia which rose further during casting (p < 0.01). Intergroup comparisons revealed that the alteration for NIPS during casting was in following sequence (Group A > C > B, p < 0.00001). The effect of interventions offered in Group B and C lasted in the post-cast period as well (B > C).

CONCLUSION:

The clubfoot child exhibited moderate pain response during casting of both feet. A tachycardia was noted prior to initiation of second cast which further exaggerated with subsequent cast. Pacifier (non-nutritive sucking) intervention produced better control of pain response than human care contact during casting for both feet.

• Authors: Anil Agarwal, Sitanshu Barik, Ankur Upadhyay, Yogesh Patel
• Journal: Archives of orthopaedic and trauma surgery (Arch Orthop Trauma Surg) Vol. 143 Issue 9 Pg. 5603-5608 (Sep 2023) ISSN: 1434-3916 [Electronic] Germany
• PMID: 37052665 (Publication Type: Journal Article, Retracted Publication)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Topics

• Infant
• Infant, Newborn
• Humans
• Child
• Clubfoot (therapy)
• Casts, Surgical
• Treatment Outcome
• Pain (etiology)