Department of Physical Therapy at Santa Catarina State University, Brazil.
Department of Physical Therapy, Hospital Sofia Feldman, Belo Horizonte, Brazil.
Pain Manag Nurs. 2021 Apr;22(2):121-132. doi: 10.1016/j.pmn.2020.07.006. Epub 2020 Aug 27.
To systematically review the literature regarding the effectiveness of different positioning methods for procedural pain relief in neonates admitted to the Neonatal Intensive Care Unit (NICU).
A systemized search of the literature was carried out by means of two independent evaluators through the systematic search of electronic index databases.
A search for relevant studies was performed in four databases (Medline, Web of Science, Scopus, and BVS-BIREME).
REVIEW/ANALYSIS METHODS: Manual searches were conducted on suitable references from the included articles, and 1,941 publications were eligible for the analysis. The flowchart for the articles' selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and in relation to bias risks according to the Physiotherapy Evidence Database (PEDro) scale.
Based on the inclusion criteria, only 20 publications remained. According to the PEDro scale, 75% of the studies presented good methodological quality, with scores between 6 and 8, and 5% scored ≤4 points. None of them were blinded in relation to the therapies, but all of them performed intergroup statistical comparisons. According to the results of this review, we recommend facilitated tucking by parents (FTP) in NICU of at least 30 minutes duration, starting 15 minutes before, during the painful procedure, and 15 minutes after to relieve pain and to stabilize the physiological, hormonal, and behavioral responses of the newborns.
Positioning should be used as a nonpharmacological strategy for procedural pain relief in newborns. This review showed that facilitated tucking by parents for 30 minutes was the best position for pain relief in premature newborns during procedures in the NICU. Positioning is recommended as a nonpharmacological method for pain relief; FTP of at least 30 minutes duration should be the first positioning choice during procedures in the NICU.
系统回顾文献，评估新生儿重症监护病房（NICU）中不同体位摆放方法对减轻操作相关疼痛的效果。
通过两名独立评估员对电子索引数据库进行系统检索，进行文献系统性搜索。
在 4 个数据库（Medline、Web of Science、Scopus 和 BVS-BIREME）中搜索相关研究。
对纳入文献的合适参考文献进行手工检索，并对 1941 篇文章进行了分析。文章选择流程图基于系统评价和荟萃分析的首选报告项目（PRISMA）标准，并根据物理治疗证据数据库（PEDro）量表评估偏倚风险。
根据纳入标准，只有 20 篇文献被保留。根据 PEDro 量表，75%的研究具有良好的方法学质量，得分在 6 到 8 分之间，5%的研究得分≤4 分。这些研究均未对治疗方法进行盲法，但均进行了组间的统计学比较。根据本综述的结果，我们建议在 NICU 中进行至少 30 分钟的父母辅助襁褓（FTP），在疼痛操作前 15 分钟开始，在操作期间、操作后 15 分钟进行，以减轻疼痛并稳定新生儿的生理、激素和行为反应。
体位应作为减轻新生儿操作相关疼痛的非药物策略。本综述表明，在 NICU 中进行操作时，30 分钟的父母辅助襁褓是缓解早产儿疼痛的最佳体位。体位是缓解疼痛的一种非药物方法；在 NICU 进行操作时，至少 30 分钟的 FTP 应作为首选体位。
