الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Nasal continuous positive airway pressure (NCPAP) is frequently used as a non-invasive respiratory support for preterm neonates. Despite great importance of NCPAP, application of it is considered one of the painful interventions in neonatal intensive care unit (NICU). The foundational first steps for prevention and management of pain and discomfort in NICU should always be a combination of non-pharmacological and pharmacological measures. Melatonin is an endogenous neurohormone which is secreted mainly from pineal gland. Melatonin has been proven to have antioxidant effect and neuroprotective effect .There are experimental and clinical data supporting analgesic effect of melatonin. The objective of this study is to assess efficacy of melatonin for pain relief in preterm neonate receiving NCPAP Patients and Methods: This is a prospective randomized controlled study after parental informed consent. Neonates were included if they are Preterm infants (27 to <37 wk. gestation) receiving NCPAP in first 3 days of life for a duration more than 24 h. Exclusion criteria were serious, life-threatening malformations, any surgical intervention, receiving other sedatives, analgesics, infants with NEC, IVH, chest tube placement and infants required mechanical ventilation before using NCPAP. Enrolled infants were divided into two groups: Intervention group and control group. Patients were enrolled from the neonatal intensive care unit of Mansoura University Children Hospital. In the intervention group, 30 neonates on NCPAP for 24 h received single oral dose of melatonin. In the control group, 30 neonates on NCPAP for 24 h received sterile water as a placebo. Melatonin was given in a dose of 5 mg /kg. Assessment of pain in both groups have been done using EDIN. Blood sample was taken after receiving treatment by 4-6 hours to both groups to assess serum melatonin level. Results: EDIN scale was lower in melatonin group after receiving melatonin for one day Conclusion: Melatonin plays an important role as analgesic for pain relief in preterm neonate receiving NCPAP so it may be used as adjuvant therapy beside non-pharmacologic measures for pain management in neonates.