University of Brasilia, Brasilia, Brazil.
World J Pediatr. 2023 Jan;19(1):35-47. doi: 10.1007/s12519-022-00601-w. Epub 2022 Sep 13.
Supporting therapies that provide stress and pain control of preterm and term newborns infants contribute positively to the neuropsychomotor development. Non-pharmacological interventions that involve manual techniques are described, considering protocols that can be reproduced by physical therapists, with positive and negative outcomes reports.
Systematic review follows PRISMA 2020 statements guidelines. Primary and specific health sciences databases (Science Direct, Pubmed, Scielo, Embase and Scopus) were consulted between October 2021 and May 2022. Articles considered were clinical trials, randomized or not, that included descriptions of the type of intervention as non-pharmacological and that studied the following outcomes: "pain" and "stress".
Fifteen articles were selected for analysis, reaching a methodological quality of at least 3 on the Jadad Scale for the Quality of Researched Sources. The non-pharmacological therapies most applied in isolation were massage, swaddling or wrapping, gentle touch and kinesthetic stimulation, and the combined therapies were non-nutritive sucking and swaddling, oral sucrose and swaddling, sensory stimulation and familiar odors, and sensory saturation. The outcomes found were relaxation, pain, and stress reduction after the application of painful procedures. The behavioral changes included crying, grimacing, yawning, sneezing, jerky arm or leg movements, startles, and finger flaring. The vital signs included heart rate, blood oxygen saturation level, and pulse respiration.
Combined techniques lead to better results in controlling neonatal pain when compared to isolated techniques. They can be applied both in preterm and term infants in a safe way and are reproducible in any health unit in a simple and economical way.
为早产儿和足月新生儿提供缓解压力和疼痛的支持疗法有助于促进神经心理运动发育。描述了涉及手动技术的非药物干预措施，考虑了可以由物理治疗师复制的方案，并报告了积极和消极的结果。
系统评价遵循 PRISMA 2020 声明指南。于 2021 年 10 月至 2022 年 5 月期间在主要和特定健康科学数据库（Science Direct、Pubmed、Scielo、Embase 和 Scopus）中进行了检索。考虑的文章为临床试验，无论是否为随机试验，均包括将干预类型描述为非药物干预，并研究了以下结果：“疼痛”和“压力”。
选择了 15 篇文章进行分析，这些文章在 Jadad 研究来源质量量表上的方法学质量至少为 3 分。最常单独应用的非药物疗法是按摩、襁褓或包裹、轻抚和运动刺激，联合疗法是非营养性吸吮和襁褓、口服蔗糖和襁褓、感觉刺激和熟悉气味以及感觉饱和。应用疼痛程序后发现的结果是放松、疼痛减轻和压力减轻。行为变化包括哭泣、皱眉、打哈欠、打喷嚏、手臂或腿部抽搐、惊吓和手指张开。生命体征包括心率、血氧饱和度水平和脉搏呼吸。
与单独技术相比，联合技术在控制新生儿疼痛方面可带来更好的结果。它们可以安全地应用于早产儿和足月儿，并且可以在任何医疗单位以简单经济的方式重复使用。
