Efficacy and safety of non‐pharmacological interventions for endotracheal suctioning pain in preterm infants: A systematic review

Abstract

Aim To review and analyse the evidence on the efficacy and safety of non‐pharmacological interventions for preterm infants to relieve endotracheal suctioning (ES) pain. Design A systematic review per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Methods Six databases were searched with a retrieval strategy. Parallel and crossover randomized controlled trials reporting non‐pharmacological interventions for relieving ES pain in preterm infants were identified from inception to 1 September 2021. The protocol was published in PROSPERO (CRD42021276058). Results Ten studies were retrieved, including nine different non‐pharmacological interventions. Seven studies reported that non‐pharmacological interventions in relieving pain were more effective than conventional care during ES, and three trials reported its safety. Due to the heterogeneity of pain assessment tools, time of assessment and population, only Facilitated tucking had sufficient evidence that it is a safe and effective non‐pharmacological intervention.

Effect of non-pharmacological interventions on pain in preterm infants in the neonatal intensive care unit: a network meta-analysis of randomized controlled trials

“…Previous systematic reviews have primarily examined the effectiveness of individual or combined non-pharmacologic interventions for the treatment of pain in preterm infants [ 13 – 15 , 17 , 18 ]. While there have been several recent systematic reviews assessing the effectiveness of different non-pharmacological interventions, it is important to note that these reviews have not encompassed the entire spectrum of interventions, and the evidence has not been consolidated [ 11 , 16 , 19 , 20 ]. As such, the objective of this network meta-analysis is to integrate various non-pharmacological interventions and evaluate their efficacy in managing pain in preterm infants, providing high-quality clinical evidence for improving pain care.…”

“…Clearly, there is a need to explore alternative, neuroprotective pain management strategies in this vulnerable population. In recent years, non-pharmacological interventions such as skin-to-skin contact, non-nutritive sucking, facilitated tucking position, breastfeeding, oral sucrose, olfactory stimulation, and music therapy have emerged as effective methods for pain management in preterm infants [11,12]. Evidence has already confirmed their efficacy and safety in pain management and some other pain-related indicators such as oxygen saturation, respiratory rate, and heart rate [13][14][15][16][17][18].…”