Does Prone or Supine Position Influence Pain Responses in Preterm Infants at 32 Weeks Gestational Age?

Objective: The purpose of this study was to examine the influence of prone and supine position in preterm infants during acute pain of blood collection. Setting: Level III Neonatal Intensive Care Unit (NICU). Study Design: Thirty-eight preterm infants (birthweight 1339 [590–2525] g, GA 29 [25–32] wks) were in 2 groups depending on their position in the isolette prior to and during heel lance at 32 weeks post-conceptional age. The study design was a comparison between groups (Prone, Supine) during 2 events (Baseline, Heel lance). Outcome Measure: Pain measures were multidimensional, including behavioral (sleep–wake state and facial activity) and physiological (heart rate) responses measured continuously prior to (Baseline) and during blood collection (Lance). Results: Both groups of infants displayed statistically significant shifts in sleep–wake state to greater arousal, and increased facial activity and heart rate, from Baseline to Lance. Prone position was associated with significantly more deep sleep during Baseline, compared with Supine position, but there were no differences in sleep-wake state during Lance. Minor increased facial activity was show