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  1. Pouraboli, Batool PhD
  2. Mirlashari, Jila PhD
  3. Fakhr, Aida Safaiee MSc
  4. Ranjbar, Hadi PhD
  5. Ashtari, Somayeh MSC


Background: Removal of a chest tube is a painful procedure for infants. Medications, including narcotics, are used to control pain, but nonpharmacologic interventions are also effective in reducing pain during this procedure and are not associated with adverse effects.


Purpose: To evaluate the additive effect of facilitated tucking to the use of morphine on infant pain associated at the time of chest tube removal.


Methods: This was a prospective, randomized control study. Sixty infants were randomized into 2 equal groups utilizing a coin flip. All infants received 0.05-mg/kg morphine 20 minutes before chest tube removal. The intervention group received facilitated tucking and the control group received standard care. Infant pain was measured using the Neonatal Infant Pain Scale. Pain was assessed at 3 time points by 2 independent evaluators: 5 minutes before, during, and 5 minutes after removal of the chest tube. Mann-Whitney and Fisher's exact (Chi-square) tests were used to compare the intervention and control groups.


Results: Pain scores were increased during chest tube removal for both the intervention and the control groups. Compared with the control group, pain scores for infants in the intervention group were less before, during, and after chest tube removal.


Implications for Practice: Facilitated tucking combined with morphine administration can be an effective additive intervention for pain control in infants during chest tube removal.


Implications for Research: Evaluate the effect of the facilitated tucking on pain induced by chest tube removal in preterm infants. Preterm infants may respond differently to pain.