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.