Faculty of Nursing,University of Alberta, Edmonton, Alberta.
Adv Neonatal Care. 2024 Aug 1;24(4):364-373. doi: 10.1097/ANC.0000000000001164. Epub 2024 Jun 22.
Small infants experience a myriad of stimuli while in the Neonatal Intensive Care Unit (NICU), with many being painful or stressful experiences, although medically necessary.
To determine what is known about nonpharmacological developmental care interventions used in the NICU to mitigate procedural pain of infants born under 32 weeks gestation.
SEARCH/STRATEGY: Five electronic databases were searched: Medline, CINAHL, Scopus, Embase and the Cochrane Library. The inclusion criteria were as follows: experimental and nonexperimental studies from all publication years with infants born at less than 32 weeks gestational age; peer-reviewed research articles studying nonpharmacological interventions such as skin-to-skin care, facilitated tucking, nonnutritive sucking, hand hugs, and swaddling; and English language articles. Our search yielded 1435 articles. After the elimination of 736 duplicates, a further 570 were deemed irrelevant based on their abstract/titles. Then, 124 full-text articles were analyzed with our inclusion and exclusion criteria.
Twenty-seven studies were reviewed. Sucrose, facilitated tucking, pacifier, skin-to-skin care, and human milk appeared to lessen pain experienced during heel sticks, suctioning, nasogastric tube insertions, and echocardiograms. All nonpharmacological interventions failed to prove efficacious to adequately manage pain during retinopathy of prematurity (ROP) examinations.
Evidence review demonstrates that healthcare practitioners should use nonpharmacological measures to help prevent pain from day-to-day procedures in the NICU including heel sticks, nasogastric tube insertions, suctioning, echocardiograms, and subcutaneous injections.
Future research is necessary to better understand and measure how pain is manifested by very small premature infants. Specific research on mitigating the pain of examinations for retinopathy of prematurity is also needed.
小婴儿在新生儿重症监护病房（NICU）中会经历各种刺激，其中许多是痛苦或有压力的体验，尽管这些体验在医学上是必要的。
确定在 NICU 中使用哪些非药物性发育护理干预措施来减轻胎龄小于 32 周的婴儿进行程序性疼痛。
搜索/策略：搜索了五个电子数据库：Medline、CINAHL、Scopus、Embase 和 Cochrane Library。纳入标准如下：所有发表年份的实验和非实验研究，研究对象为胎龄小于 32 周的婴儿；同行评议的研究文章，研究非药物干预措施，如皮肤接触、促进包裹、非营养吸吮、手拥抱和襁褓；以及英语文章。我们的搜索结果为 1435 篇文章。消除 736 篇重复文章后，根据摘要/标题，进一步排除了 570 篇不相关的文章。然后，分析了 124 篇全文文章，纳入和排除标准。
综述了 27 项研究。蔗糖、促进包裹、奶嘴、皮肤接触和人乳似乎可以减轻足跟穿刺、吸引、鼻胃管插入和超声心动图检查时的疼痛。所有非药物干预措施都未能证明在早产儿视网膜病变（ROP）检查中有效地缓解疼痛。
证据回顾表明，医护人员应使用非药物措施来帮助预防 NICU 日常程序引起的疼痛，包括足跟穿刺、鼻胃管插入、吸引、超声心动图和皮下注射。
需要进一步研究以更好地了解和衡量非常小的早产儿的疼痛表现。还需要专门研究减轻早产儿视网膜病变检查疼痛的方法。
