Ding Shenglan, Wang Qingxia, Fu Xiujuan, Huang Xiuhua, Liao Luxi, Zhang Yilan
Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China.
Surgery Intensive Care Unit, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China.
Int J Nurs Stud. 2025 May;165:105031. doi: 10.1016/j.ijnurstu.2025.105031. Epub 2025 Feb 19.
This study aims to compare and rank the effects of acoustic stimulation on painful procedures in both preterm and full-term infants.
Six databases including Medline, Web of Science, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, and SinoMed, were searched from inception to July, 2023. A Bayesian network meta-analysis with random effects models was performed using R software and Stata 15.0. The quality of included studies was assessed using the Cochrane Collaboration's tool. The study protocol was registered at PROSPERO (Registration number: CRD42023451102).
A total of 28 studies involving 2624 preterm and full-term infants were included and 8 acoustic stimulation interventions were identified. Regarding pain levels during procedures, maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, vocal music therapy, white noise, and white noise plus were significantly more effective than control group [standardized mean differences (SMD) ranged from -2.6 to -0.87]. White noise plus was the most effective intervention for reducing pain levels during procedures (90.6 %). Regarding pain levels after procedures (no specific time mentioned), maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, other non-pharmaceutical interventions, routine care, vocal music therapy, and white noise plus were significantly more effective than control group (SMD ranged from -4.7 to -1.6). Music therapy and maternal voice plus was the most effective intervention for reducing pain levels after procedures, without specific time mentioned (95.29 %). Regarding pain levels 1 min after procedures, only music therapy plus and other pharmaceutical interventions were effective (SMD ranged from -4.5 to -4.9) and music therapy plus was the most effective intervention (93.41 %). No interventions had significant effects on pain levels 3, 5, and 10 min after procedures. Regarding heart rate, only white noise plus could provide a lower increase during procedures. For oxygen saturation, only vocal music therapy could provide a lower decrease after painful procedures (no specific time mentioned). No interventions had significant effects on stabilizing respiratory rate.
This review suggests that multiple acoustic stimulation interventions are effective for pain relief in both preterm and full-term infants undergoing painful procedures. More high quality studies with larger sample size are required to generate evidence regarding the short- and long-term effectiveness and safety of acoustic stimulation interventions on painful procedures.
本研究旨在比较并排序听觉刺激对早产儿和足月儿疼痛性操作的影响。
检索了6个数据库，包括Medline、Web of Science、Cochrane对照试验中心注册库、护理及相关健康文献累积索引、Embase和中国生物医学文献数据库，检索时间从建库至2023年7月。使用R软件和Stata 15.0进行了随机效应模型的贝叶斯网络meta分析。采用Cochrane协作网的工具评估纳入研究的质量。该研究方案已在PROSPERO注册（注册号：CRD42023451102）。
共纳入28项研究，涉及2624例早产儿和足月儿，确定了8种听觉刺激干预措施。关于操作过程中的疼痛水平，母亲声音、母亲声音加、音乐疗法、母亲声音加音乐疗法加、其他药物干预、声乐音乐疗法、白噪声、白噪声加均显著优于对照组[标准化均数差（SMD）范围为-2.6至-0.87]。白噪声加是降低操作过程中疼痛水平最有效的干预措施（90.6%）。关于操作后（未提及具体时间）的疼痛水平，母亲声音、母亲声音加、音乐疗法、母亲声音加音乐疗法加、其他药物干预、其他非药物干预、常规护理、声乐音乐疗法、白噪声加均显著优于对照组（SMD范围为-4.7至-1.6）。音乐疗法和母亲声音加是降低未提及具体时间的操作后疼痛水平最有效的干预措施（95.29%）。关于操作后1分钟的疼痛水平，只有音乐疗法加和其他药物干预有效（SMD范围为-4.5至-4.9），音乐疗法加是最有效的干预措施（93.41%）。没有干预措施对操作后3、5和10分钟的疼痛水平有显著影响。关于心率，只有白噪声加在操作过程中能使心率升高幅度更低。对于血氧饱和度，只有声乐音乐疗法在疼痛性操作后（未提及具体时间）能使血氧饱和度下降幅度更低。没有干预措施对稳定呼吸频率有显著影响。
本综述表明，多种听觉刺激干预措施对接受疼痛性操作的早产儿和足月儿缓解疼痛有效。需要更多样本量更大的高质量研究来提供关于听觉刺激干预措施对疼痛性操作的短期和长期有效性及安全性的证据。
