General Hospital Mancha Centre (HGMC), Castilla-La Mancha Health Service (SESCAM), 13600 Alcázar de San Juan, Spain.
Department of Physical Activity and Sports Sciences, University of Castilla-La Mancha, Toledo Campus, 45071 Toledo, Spain.
Int J Environ Res Public Health. 2023 Feb 12;20(4):3226. doi: 10.3390/ijerph20043226.
In neonatology, neonates have traditionally been considered incapable of feeling pain, due to the immaturity of their nervous system. Currently, there is sufficient information on the perception of pain in neonates; however, this treatment at this crucial stage for development requires a better approach. For this reason, the aim of this study was to analyse the efficacy of non-pharmacological analgesia interventions during heel prick, and to assess their effects on heart rate (HR), premature infant pain profile (PIPP) and O saturation. A systematic review and meta-analysis was performed following the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA), and the Cochrane collaboration handbook. The databases PubMed, Cochrane Library, Web of Science, Scopus, CINAHL and Science Direct were searched until the end of January 2022. The DerSimonian and Laird methods were used to estimate the effect size with a 95% confidence interval (CI95%). Effect size estimates were 0.05 (95% CI: -0.19, 0.29) for HR, -0.02 (95% CI: -0.24, 0.21) for PIPP scale, and -0.12 (95% CI: -0.29, 0.05) for O saturation. The non-pharmacological interventions analysed (breastfeeding, kangaroo-mother care method, oral sucrose and non-nutritive sucking) were not statistically significant in reducing neonatal pain, but did influence the decrease in pain score and a faster stabilisation of vital signs.
在新生儿学中，由于新生儿神经系统尚未成熟，传统上认为他们无法感受到疼痛。目前，已经有足够的信息表明新生儿能够感知疼痛；然而，在这个发育关键阶段的治疗需要更好的方法。出于这个原因，本研究的目的是分析足跟采血时非药物性镇痛干预的效果，并评估其对心率（HR）、早产儿疼痛概况（PIPP）和 O 饱和度的影响。本研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）和 Cochrane 协作手册的指南进行了系统评价和荟萃分析。检索了 PubMed、Cochrane 图书馆、Web of Science、Scopus、CINAHL 和 Science Direct 数据库，直到 2022 年 1 月底。使用 DerSimonian 和 Laird 方法估计具有 95%置信区间（CI95%）的效应量。HR 的效应量估计值为 0.05（95%CI：-0.19，0.29），PIPP 量表的效应量估计值为-0.02（95%CI：-0.24，0.21），O 饱和度的效应量估计值为-0.12（95%CI：-0.29，0.05）。分析的非药物干预措施（母乳喂养、袋鼠式母亲护理方法、口服蔗糖和非营养性吸吮）在降低新生儿疼痛方面没有统计学意义，但确实影响了疼痛评分的降低和生命体征的更快稳定。
