Effect of Multisensory Stimulation on Pain During Heel Lance in Newborns
The Effect of Multisensory Stimulation Applied During Heel Blood Sampling on Pain and Physiological Parameters in Newborns: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Heel blood sampling is a routine procedure used in newborn screening; however, it can produce pain, crying, and short-term changes in physiological parameters such as heart rate and oxygen saturation. Non-pharmacological approaches are commonly used to reduce procedural pain in newborns, but the effects of individual methods may be inconsistent. Multisensory stimulation combines several familiar and comforting sensory inputs and may reduce pain by directing attention away from the procedure, supporting autonomic regulation, and decreasing the stress response.
In this study, multisensory stimulation will consist of breastfeeding, gentle stroking of the leg, maternal singing or lullaby, and continuous eye contact between the mother and newborn. Breastfeeding and gentle stroking will begin 10 minutes before heel blood sampling and continue until 5 minutes after the procedure. Maternal singing and eye contact will be maintained throughout the procedure. The control condition will reflect supportive routine care, with the newborn held in the mother's arms during heel blood sampling.
The study will examine whether this structured multisensory approach reduces procedural pain and crying and supports physiological stability in healthy newborns. Pain, heart rate, and oxygen saturation will be assessed before, during, and after heel blood sampling. Crying duration and total procedure duration will also be recorded. The findings may contribute to the development of a safe, practical, and standardized non-pharmacological approach to pain management during routine newborn procedures.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: İlçim Ercan-Koyuncu, PhD
- Phone Number: +905534700629
- Email: ilcimercan@hotmail.com
Study Locations
-
-
Beşevler
-
Ankara, Beşevler, Turkey (Türkiye), 60300
- Recruiting
- Tatvan State Hospital
-
Contact:
- İlçim Ercan-Koyuncu
- Phone Number: 05534700629
- Email: ilcimercan@hotmail.com
-
-
Bitlis
-
Bitlis, Bitlis, Turkey (Türkiye), 60300
- Recruiting
- Bitlis State Hospita
-
Contact:
- İlçim Ercan-Koyuncu
- Phone Number: 05534700629
- Email: ilcimercan@hotmail.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Healthy newborns aged 0-28 days
- Newborns receiving routine monitoring and care with their mothers in the hospital's newborn care unit
- Written informed consent provided by the newborn's parent or legal representative
Exclusion Criteria:
- Presence of any lower-extremity anomaly
- Ongoing monitoring or treatment in the neonatal intensive care unit
- Presence of a congenital disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Multisensory Stimulation Group
Newborns assigned to this arm will receive a structured multisensory stimulation intervention during heel blood sampling.
The intervention will include breastfeeding, gentle stroking of the leg, maternal singing or lullaby, and continuous eye contact between the mother and newborn.
Breastfeeding and gentle stroking will begin 10 minutes before the procedure and continue until 5 minutes after the procedure.
Maternal singing and eye contact will be maintained throughout heel blood sampling.
|
The multisensory stimulation intervention consists of four components: breastfeeding, gentle stroking, maternal singing or lullaby, and eye contact.
Breastfeeding will begin 10 minutes before heel blood sampling and continue until 5 minutes after the procedure.
During the same 15-minute period, the mother will gently stroke the newborn's leg from which the heel blood sample will be obtained.
Throughout the heel blood sampling procedure, the mother will sing a lullaby or song in a soft and calm voice and maintain continuous eye contact with the newborn.
No standardized song or lullaby will be prescribed, and the sound level will remain within the range of natural mother-newborn communication.
|
|
No Intervention: Mother's Arms Control Group
Newborns assigned to this arm will receive routine heel blood sampling while being held in their mother's arms.
No additional structured non-pharmacological pain-reduction intervention will be administered.
When necessary, the mother may gently hold and support the newborn in a comfortable position during the procedure.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
N-PASS Pain Score
Time Frame: Immediately before, during, and immediately after heel blood sampling.
|
Newborn pain will be assessed using the Neonatal Pain, Agitation and Sedation Scale (N-PASS).
The scale evaluates crying or irritability, behavioral state, facial expression, extremity tone or body tension, and changes in vital signs.
Higher pain scores indicate greater pain or agitation.
|
Immediately before, during, and immediately after heel blood sampling.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Crying Duration
Time Frame: During the heel blood sampling session.
|
The total duration of crying associated with heel blood sampling will be measured using a stopwatch and recorded in seconds.
A shorter crying duration indicates a more favorable outcome.
|
During the heel blood sampling session.
|
|
Heart Rate
Time Frame: Immediately before, during, and immediately after heel blood sampling.
|
Heart rate will be measured non-invasively using a bedside pulse oximeter and recorded as beats per minute.
Heart rate values will be assessed to determine physiological responses to heel blood sampling and the multisensory stimulation intervention.
|
Immediately before, during, and immediately after heel blood sampling.
|
|
Oxygen Saturation
Time Frame: Immediately before, during, and immediately after heel blood sampling.
|
Peripheral oxygen saturation will be measured non-invasively using a bedside pulse oximeter and recorded as a percentage.
Higher and more stable oxygen saturation values indicate a more favorable physiological response.
|
Immediately before, during, and immediately after heel blood sampling.
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Procedure Duration
Time Frame: During a single heel blood sampling procedure
|
The total duration of the heel blood sampling procedure will be measured using a stopwatch and recorded in seconds.
|
During a single heel blood sampling procedure
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Garcia-Valdivieso I, Yanez-Araque B, Moncunill-Martinez E, Bocos-Reglero MJ, Gomez-Cantarino S. Effect of Non-Pharmacological Methods in the Reduction of Neonatal Pain: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2023 Feb 12;20(4):3226. doi: 10.3390/ijerph20043226.
- Jin L, Zhang J, Yang X, Rong H. Maternal voice reduces procedural pain in neonates: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Mar 24;102(12):e33060. doi: 10.1097/MD.0000000000033060.
- Sahin K, Yildiz S, Gur E. The effect of multi-sensory stimuli used during vaccination on pain and physiological parameters in infants: A randomized controlled trial. J Pediatr Nurs. 2026 Mar-Apr;87:20-30. doi: 10.1016/j.pedn.2025.11.051. Epub 2026 Jan 6.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MSS-HEEL-RCT-2026-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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