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Comparative Efficacy of Interventions for Analgesia During Heel Prick in Newborn Infants - A Systematic Review and Network Meta-Analysis.
Abiramalatha, Thangaraj; Ramaswamy, Viraraghavan Vadakkencherry; Anne, Rajendra Prasad; Amuji, Nalina; Thinesh, Jayaraman; Venkateshwarlu, Vardhelli; Rao, Vadije Praveen; Shaik, Nasreen Banu; Pullattayil, Abdul Kareem; Balachander, Bharathi; Sivanandhan, Sindhu; Kumar, Jogender; Gupta, Neeraj; Chawla, Deepak; Kumar, Praveen; Rao, Suman.
Afiliación
  • Abiramalatha T; Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, Tamil Nadu, India.
  • Ramaswamy VV; Ankura Hospital for Women and Children, Hyderabad, Telangana, India.
  • Anne RP; Department of Neonatology, Kasturba Medical College, Manipal, Karnataka, India. Correspondence to: Dr Rajendra Prasad Anne, Assistant Professor, Department of Neonatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education (MAHE), Karnataka, India. rajendra.anne@manipal.edu.
  • Amuji N; Department of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, India.
  • Thinesh J; Rainbow Children's Hospital, Chennai, Tamilnadu, India.
  • Venkateshwarlu V; The Birthplace by Cloudnine Hospital, Hyderabad, Telangana, India.
  • Rao VP; Cloudnine Hospital, Hitech City, Hyderabad, Telangana, India.
  • Shaik NB; Ankura Hospital for Women and Children, Hyderabad, Telangana, India.
  • Pullattayil AK; Health Sciences Librarian, Queen's University, Kingston, Canada.
  • Balachander B; Department of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, India.
  • Sivanandhan S; Kauvery Hospital, Radial Road, Kovilambakkam, Chennai, Tamilnadu, India.
  • Kumar J; Newborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
  • Gupta N; Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
  • Chawla D; Department of Neonatology, Government Medical College Hospital, Chandigarh, India.
  • Kumar P; Newborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
  • Rao S; Department of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, India.
Indian Pediatr ; 61(9): 851-875, 2024 Sep 15.
Article en En | MEDLINE | ID: mdl-39193923
ABSTRACT
CONTEXT Heel prick is one among the common painful procedures in neonates. We performed a systematic review and network meta-analysis (NMA) to compare the efficacy of different interventions for analgesia during heel prick in neonates. EVIDENCE ACQUISITION Medline, Cochrane, Embase and CINAHL databases were searched from inception until February 2023. Randomized and quasi-randomized trials that evaluated different pharmacological and non-pharmacological interventions for analgesia during heel prick for neonates were included. Data from the included trials were extracted in duplicate. A NMA with a frequentist random-effects model was used for data synthesis. Certainty of evidence (CoE) was assessed using GRADE. We adhered to the PRISMA-NMA guidelines.

RESULTS:

One-hundred-and-three trials comparing 51 different analgesic measures were included. Among the 38 interventions, for pain "during" heel prick, non-nutritive suckling (NNS) plus sucrose [SMD -3.15 (-2.62, -3.69)], followed by breastfeeding, glucose, expressed breast milk (EBM), sucrose, NNS and touch massage, had a high certainty of evidence (CoE) to reduce pain scores when compared to no intervention. Among the 23 interventions for pain at 30 seconds after heel-prick, moderate CoE was noted for facilitated tucking plus NNS plus music, glucose, NNS plus sucrose, sucrose plus swaddling, mother holding, EBM, sucrose and NNS.

CONCLUSIONS:

Oral sucrose 2 minutes before combined with NNS during the procedure, was the best intervention for reducing pain during heel prick. It also effectively reduced pain scores 30 seconds and 1 minute after the procedure. Other interventions with moderate to high CoE for a significant reduction in pain during and at 30 seconds after heel prick are oral sucrose, oral glucose, EBM and NNS. All these are low-cost and feasible interventions for most of the settings.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Talón / Manejo del Dolor / Analgesia Límite: Humans / Newborn Idioma: En Revista: Indian Pediatr Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India
Buscar en Google
Añadir a Mi BVS
Imprimir
XML
PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Talón / Manejo del Dolor / Analgesia Límite: Humans / Newborn Idioma: En Revista: Indian Pediatr Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India