Effect of music intervention on pain responses in premature infants undergoing placement procedures of peripherally inserted central venous catheter: A randomized controlled trial

Abstract Introduction Premature infants are highly sensitive to pain because of their immature and vulnerable nervous systems, which lead to peripherally inserted central venous catheter (PICC) difficulty. The objective of this study was to investigate the application of a music intervention (MI) during PICC placement procedures in premature infants. Methods A randomized controlled trial was conducted on sixty premature infants (gestational age of 28 weeks to 36 weeks). Infants hospitalized to receive PICC puncture and meeting the study entry criteria were randomly assigned to an MI group ( n  = 30) or a control group (n = 30). The effects of MI were assessed by determination of heart rate, blood oxygen saturation, pain rating, cortisol concentration and operating time during PICC placement procedures in both groups. Furthermore, pain level was identified using premature infant pain profile. Results There was no statistically significant difference between the two groups in terms of heart rate, blood oxygen saturation and pain score before intervention ( P >  0.05). During PICC placement procedures, a significant increase in term of blood oxygen saturation ( P   0.05) and reductions in terms of heart rate ( P   0.05) and cortisol accumulation were observed in the group receiving music intervention compared with the control group. Furthermore, MI led to a significant reduction in pain score (mean difference: 3.4, 95% confidence interval: [2.0, 4.8]), and remarkably decreased the time needed for PICC placement in the MI group compared to control group. Conclusions During PICC placement procedures for premature infants, MI significantly reduced stress hormone levels, physiological parameters and behavioral response of pain.