The Effect Of Non-pharmacological Interventions For Alleviating Neonatal Pain Caused By Invasive Nursing Procedures: A Systematic Review

Objective To evaluate the effect of non-pharmacological interventions(non-nutritive sucking,kangaroo care,breast feeding,oral sucrose or glucose) for alleviating neonatal pain caused by invasive nursing procedures systematically,so as to provide evidence-based-nursing proof for the clinical about neonatal pain management.Methods To retrieve PUBMED, EBSCO, OVID, EMBASE, Cochrane Library, CNKI, CBM by computer,at the same time,reference retrieval and manual searching were needed to acquire Chinese and English literatures of randomized controlled trials(RCTs) and clinical controlled trials(CCTs) about non-pharmacological interventions for alleviating neonatal pain caused by invasive nursing procedures around the world comprehensively.According to inclusion and exclusion criteria,documents screening,quality assessment of methodology,data extraction were done by two researchers respectively.RevMan5.0.25 statistical software was adopted to do Meta-analysis.Results Thirty-two literatures of RCTs and CCTs via screening were included to do a systematic review.There were 21 literatures of high quality and 11 literatures of low quality according to improved Jadad scale score,the quality of research was better on the whole.The results of Meta-analysis were as follows:1.Non-nutritive sucking(NNS) vs. usual care could more stabilize heart rate(HR) during and after heel lance,blood oxygen saturation(SaO₂) after heel lance(P<0.01),shorten crying and grimacing duration time when heel lance and diminish crying proportion after heel lance (P<0.01),reduce PIPP score,DAN score,NIPS score,NFCS score when invasive nursing procedures(P<0.05);2.Kangaroo care(KC) compared with swaddling or blank control could more stabilize HR and SaO₂ during and after invasive nursing procedures(P<0.01),shorten crying and grimacing duration time during and after invasive nursing procedures,diminish crying and grimacing proportion after invasive nursing procedures(P<0.01),reduce NFCS score when invasive nursing procedures(P<0.01);3.Breast feeding vs. usual care could more stabilize SaO₂ during invasive nursing procedures(P<0.01),shorten crying and grimacing duration time,diminish crying and grimacing proportion during and after invasive nursing procedures(P<0.05),decrease NIPS score when invasive nursing procedures(P<0.01);4.Oral glucose vs. placebo could more stabilize HR during and after invasive nursing procedures(P<0.01),diminish crying proportion during and after invasive nursing procedures (P<0.05),decrease PIPP score and NFCS score when invasive nursing procedures (P<0.05);5.Oral sucrose compared with distilled water or sterile water could shorten crying duration time when heel lance(P<0.01),reduce PIPP score at 30 seconds and 1 minute after heel lance(P<0.01).Conclusion This study indicated:①NNS,KC,breast feeding compared with usual care could relieve behavioral response of neonatal pain;②KC vs. usual care could alleviate physiological response of neonatal pain;③NNS,KC,breast feeding compared with usual care could decrease neonatal pain scale score;④Oral glucose or sucrose compared with placebo could reduce neonatal pain scale score;⑤Oral glucose or sucrose vs. placebo couldn't relieve physiological and behavioral response of neonatal pain.Because of scanty related studies included in any kind of non-pharmacological interventions,more RCTs with strict design and large sample were still needed to further raise intensity of the proof.