Copyright
©The Author(s) 2021.
World J Clin Cases. Jul 26, 2021; 9(21): 5921-5931
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5921
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5921
Table 2 Studies characteristics included in the review
Ref. | Level of Evidence | Research Design | Pain Assessment | Pain Management | Painful Procedures | Aim |
Gonzalez et al[3] | Ia | Systematic review | Scales: NIPS, PIPP, CRIES, NFCS, COMFORT | NPI: Environmental, behavioral and nutritional intervention: sucrose, dummy (non-nutritive suction), kangaroo method or skin to skin.PI: Paracetamol, morphine, ketamine, metamizole, thiopental, chloral hydrate… | Venipuncture, lumbar/heel puncture, peripheral/central venous catheter insertion, umbilical catheterization, injections, aspiration, orogastric catheterization | To know the neonatal pain impact and its treatment in painful procedures. Purpose: To sensitize health professionals about pain management in NBs |
Avila-Alvarez et al[21] | III | Multicenter, observational, longitudinal and prospective study | NA | NPI: Sweet oral solution: Sucrose (most common) and glucose. PI: Fentanyl (most used), midazolam, morphine, paracetamol | Invasive and non-invasive mechanical ventilation | To determine the clinical practice in relation to sedation and analgesia in Spanish ICUs and to identify factors associated with the use of drugs |
Guzmán et al[10] | III | Prospective-descriptive pilot study | Observational: Signs of pain (crying), contraction of facial muscles, heart rate and respiratory rate | Sentire method: Psychotherapeutic pain management through music and touch | Clinical procedures, separation from mother, ambient noise > 45 dB | Analyze the effectiveness of the Sentire method |
San Martín et al[11] | III | Descriptive correlational cross-sectional study | Susan Givens-Bell Scale | NA | Venous and arterial puncture, orogastric catheterization, aspiration of secretions | Assess the pain intensity in NB against nursing procedures |
Aguilar et al[22] | Ia | Systematic review | Most employed: PIPP and NIPS | NPI: Oral administration of sweet solutions, breastfeeding and kangaroo care | Heel puncture, injections and vaccines, venous lines cannulation | To analyze studies that assess the effectiveness of NPIs during painful procedures |
Avila-Alvarez et al[5] | III | Observational longitudinal prospective study | Most used scales: NIPS, CRIES and Susan-Givens. Others: PIPP, NPASS, COMFORT | PI: Sedative or analgesic medication | Invasive mechanical ventilation | To determine the clinical practice in relation to the assessment of neonatal pain in Spain and the factors associated with the use of scales |
Veronez et al[12] | III | Qualitative descriptive study | Observation: Crying, facial expression, irritability and agitation. Physiological alterations: Heart rate, blood pressure, respiratory parameters, etc | NPI(mild pain): Oral glucose administration, non-nutritive suction, group procedures, environmental measuresPI (severe pain): Non-opioid and opioid analgesics | Venous puncture, capillary glycemia, adhesive removal, tracheal aspiration, dressings… | Describe the perception of neonatal pain by ICU nursing professionals |
Do Prado et al[13] | Ia | Systematic review | Physiological and behavioral alterations. Scales: NIPS, NFCS, PIPP, CRIES, N-PAS | NPI: Oral glucose and non-nutritive suction (most used), environmental and postural care, breastfeeding… PI: NSAIDs, opioids, sedatives, local anesthetics | Venipuncture, blood collection, gastric catheterization, intubation… | To analyze the Brazilian scientific production on the evaluation and therapeutic approach of pain in newborns admitted to NICU |
Thomé et al[14] | III | Cross-sectional study | NIPS scale | NA | Orotracheal tube and airway aspiration, venipuncture, intubation and insertion of PICC | Assess pain in NBs admitted to the NICU during invasive procedures |
Do Nascimento et al[15] | III | Descriptive exploratory study with a qualitative approach | Physiological and behavioral responses. Scales: NFCS, NIPS and PIPP | NPI: Non-nutritive suction, positioning and containment. PI: Opioids, topical analgesics and sedatives | Diagnostic, surgical and therapeutic procedures: Venipuncture, capillary blood glucose, improper management, orotracheal aspiration… | Identify how the nursing staff assesses and manages NB pain in the NICU |
Costa et al[16] | III | Descriptive cross-sectional study | Scales: NIPS, CRIES. Physiological and behavioral alterations | NPI: Oral glucose, non-nutritive sucking and laying. PI: Paracetamol, fentanyl and morphine | Venous punctures, tracheal aspirations, surgeries | Verify the nurses knowledge and practices about NBs pain management admitted to the NICU |
Bonolo et al[17] | III | Descriptive exploratory study | Physiological and behavioral indicators: Heart rate, facial expression, cryingScales: CRIES, PIPP, NIPS, NFCS, N-PASS | NPI: Positioning, non-nutritive suction, environmental measures. PI: Opioids, NSAIDs, local anesthetics | Venipuncture, overhandling, heel stick, blood draw, aspiration | To characterize the nursing staff and identify how it assesses and manages pain for preterm newborns |
Alves et al[18] | III | Convergent care study | Escala: PASVital signs daily assessment | NPI: Reducing environmental stimulus, grouping procedures and promoting sleep, kangaroo mother care, containment during procedures, administration of oral glucose, non-nutritive sucking | Environmental stimulus and invasive procedures: Venous/arterial puncture, oro/nasogastric catheterization, endotracheal aspiration, lumbar puncture | Develop a nursing care plan based on non-pharmacological methods for neonatal pain treatment in ICUs. |
Assunçao et al[19] | Ia | Exploratory qualitative bibliographic review | Physiological indicators (heart rate, respiratory rate, oxygen saturation) and behavioral (crying, facial expression and motor activity). Scales: NFCS, NIPS, PIPP | NPI: Non-nutritive suction, oral glucose/sucrose, positioning, skin-to-skin contact, environmental measures… PI: Opioids (morphine, fentanyl) non-opioids (acetaminophen, dipyrone) and sedatives (propofol, midazolam, diazepam) | Mechanical ventilation, postoperative period, insertion of central catheter and thoracic drains | Analyze the evaluation and intervention methods of neonatal pain and reflect on the nurse competence in the control and management of pain |
Stevens et al[24] | Ia | Literature review of randomized control trials | Scales: PIPP, DAN, NIPS, NFCS, NAPI, N-PASS, BPSN. Physiological and behavioral indicators | NPI: Sucrose administration (most effective in combination with other interventions, such as non-nutritive sucking) | Heel puncture, venous/arterial puncture, injections, bladder and nasogastric catheterization, circumcision, retinopathy of prematurity eye exam | To determine the efficacy, dose and method of sucrose administration for pain relief during procedures in the NB |
Desai et al[25] | III | Scales: N-PASS and NIPS | NA | Laboratory tests, venous/arterial puncture, intubation, aspirations… | To improve newborns acute and chronic pain measurements in a NICU by implementing the N-PASS scale | |
Santos et al[20] | III | Qualitative descriptive study | Physiological and behavioral indicators (heart rate, breath rate, crying, facial expression..) | NPI: Containment, environmental measures (light and noise), touch, skin-to-skin contact, non-nutritive suction and glucose | Venous punctures, orogastric and bladder catheterization, capillary blood glucose, dressings, airway aspiration, orotracheal intubation | Analyze the parameters used by the nursing team to assess pain and intervention in the premature newborn |
Dionysakopoulo et al[23] | III | Cross-sectional study | Most used scales: NIPS, PIPP Others: CRIES, NFCS, OPS, PAT, N-PASS | NA | Venipuncture, airway aspiration, tube placement and removal… | Evaluation and validation of scales (NIPS-PIPP) in hospitalized newborns in two Greek ICUs |
- Citation: Garcia-Rodriguez MT, Bujan-Bravo S, Seijo-Bestilleiro R, Gonzalez-Martin C. Pain assessment and management in the newborn: A systematized review. World J Clin Cases 2021; 9(21): 5921-5931
- URL: https://www.wjgnet.com/2307-8960/full/v9/i21/5921.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i21.5921