Effect of Tuina Massage on Pain during Orogastric Tube Insertion in Premature Neonates: A Randomized Controlled Trial

Background: Orogastric tube insertion is a painful procedure for neonates, particularly premature infants who are more vulnerable to pain and its consequences. Non-pharmacological, safe, and cost-effective pain management methods are essential in neonatal care. Tuina, a traditional Chinese massage technique, may reduce procedural pain in this population. This study aimed to evaluate the effect of Tuina massage on pain during orogastric tube insertion in premature neonates.Methods: A randomized controlled trial was conducted on 70 premature neonates admitted to a maternal and neonatal hospital in Ahvaz, Iran. Participants were randomly assigned into intervention (Tuina massage) and control (routine care) groups (n=35 each) using block randomization with R software. Pain levels, heart rate, and oxygen saturation were assessed using the Premature Infant Pain Profile (PIPP) at three time points: five minutes before, during, and five minutes after tube insertion. The intervention group received Tuina massage three times, each lasting one minute with 30-second intervals during these phases.Results: The intervention group showed a significant reduction in pain scores during and after tube insertion compared to the control group (p = 0.001, Cohen’s d = 0.927). Heart rate decreased and oxygen saturation increased significantly post-intervention in the Tuina group (p = 0.029).Conclusion: Tuina massage is an effective, accessible, and low-cost method for reducing procedural pain and improving physiological parameters in premature neonates, supporting its use as a valuable non-pharmacological intervention in NICU settings.