A Systematic Review of Non-Pharmacological Management of Heel-Stick Pain in the Pre-Term Neonates

Purpose:

To identify effective non-pharmacological interventions in the literature regarding Heel Stick Pain prevention and treatment in preterm neonates.

Methods:

A literature search from 2007 to 2012 was conducted using MedLine, CINAHL, and the Cochrane Library databases, and was complemented by a search of known articles. Two independent reviewers extracted data and assessed methodological quality according to pre-defined criteria.

Results:

 We identified 14 randomized controlled studies that pertained to non-pharmacological pain management methods. The selected interventions were "non-nutritive sucking"," sucrose "," glucose " ," sensorial saturation ", "facilitated tucking", "kangaroo care", " sensorial saturation", " breast milk " and "incubator care(inclined, nested, and prone)". Some of the non-pharmacological interventions reduced changes in pulse rate, respiration and oxygen saturation, motor activity, and clinical excitation states during painful intervention.

Conclusion:

Evidence supported "non-nutritive sucking"," sucrose "," glucose" ," sensorial saturation ", "facilitated tucking" and "kangaroo care" for their pain-alleviating effects on neonates. However, unambiguous evidence of their effects remains to be presented. Further research must use validated pain assessment instruments for the evaluation of the pain-alleviating effect of non-pharmacological interventions.