[The efficacy of non-pharmacological interventions in the management of pain in preterm and term neonates. A systematic literature review]

Abstract

Many diagnostic and therapeutic procedures performed in the neonatal intensive care unit are painful for the preterm or term infant. Pain is therefore a central issue in neonatal intensive care nursing. As significant side effects are associated with analgesics, non-pharmacological methods of pain prevention and relief are being favoured over pharmacological therapy. This development is very important for the nursing profession since non-pharmacological interventions are determined and carried out without an order from a physician. This review of the current literature investigates the efficacy of non-pharmacological nursing interventions in the management of pain in the neonatal intensive care unit. Despite certain methodological problems with some of the studies included in this review, the trend favours non-pharmacological interventions. Modulation of arousal and excitability during and after a painful stimulus as well as an effect on physiological and behavioural parameters have been described following non-pharmacological interventions. The studies reviewed suggest that neonates show fewer signs of pain and stress after non-pharmacological interventions for prevention and relief of pain.