Best evidence summary on non-pharmacological management of procedural pain in NICU preterm infants: an evidence synthesis and overview of reviews.
- 1Department of Neonatology, Affiliated Central People's Hospital, China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
- 2Department of Obstetrics and Gynecology, Affiliated Central People's Hospital, China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
Abstract
Preterm infants in neonatal intensive care units (NICUs) frequently undergo painful procedures. Non-pharmacological interventions have been recommended as safe and feasible options for pain relief, but evidence on their specific operational parameters has not been well synthesized. This evidence synthesis aimed to summarize the best available evidence on non-pharmacological interventions for procedural pain management in this population. Based on the evidence pyramid model, multiple databases and other resources were systematically searched from inception to May 2026. Guidelines, systematic reviews, evidence summaries, clinical decisions, expert consensus, policy statements, and randomized controlled trials were included. Methodological quality was appraised using the Appraisal of Guidelines for Research & Evaluation II (AGREE Ⅱ) instrument, Joanna Briggs Institute (JBI) checklists, and the Critical Appraisal for Summaries of Evidence (CASE) tool, with evidence graded using the JBI Levels of Evidence and Grades of Recommendation system. Literature screening, quality appraisal, and evidence extraction were independently performed by two researchers. A total of 49 publications were included. Thirty-eight pieces of best evidence were synthesized across eleven domains: general principles, non-nutritive sucking, sweet-tasting solutions, breastfeeding, kangaroo mother care or skin-to-skin contact, facilitated tucking or flexed positioning, white noise, music intervention, maternal voice stimulation, breast milk odor, and combined non-pharmacological interventions. This study provides a synthesized evidence base for non-pharmacological management of procedural pain in NICU preterm infants. The findings may inform the development of standardized pain management protocols and facilitate the translation of evidence into clinical practice. Limitations include the absence of systematic stratified analyses across all gestational age subgroups and potential language bias, as only English and Chinese publications were included.
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BibTeX
@article{lan2026best,
title = {{Best evidence summary on non-pharmacological management of procedural pain in NICU preterm infants: an evidence synthesis and overview of reviews.}},
author = {Fenfen Lan and Lin Li and Zhaohua Huo and Yuanyuan Wang and Juan Liu},
journal = {Translational pediatrics},
year = {2026},
month = sep,
doi = {10.21037/tp-2026-0727},
url = {https://europepmc.org/article/MED/42996384},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Best evidence summary on non-pharmacological management of procedural pain in NICU preterm infants: an evidence synthesis and overview of reviews.
AU - Fenfen Lan
AU - Lin Li
AU - Zhaohua Huo
AU - Yuanyuan Wang
AU - Juan Liu
PY - 2026
DA - 2026/09/30
JO - Translational pediatrics
DO - 10.21037/tp-2026-0727
UR - https://europepmc.org/article/MED/42996384
AB - Preterm infants in neonatal intensive care units (NICUs) frequently undergo painful procedures. Non-pharmacological interventions have been recommended as safe and feasible options for pain relief, but evidence on their specific operational parameters has not been well synthesized. This evidence synthesis aimed to summarize the best available evidence on non-pharmacological interventions for procedural pain management in this population. Based on the evidence pyramid model, multiple databases and other resources were systematically searched from inception to May 2026. Guidelines, systematic reviews, evidence summaries, clinical decisions, expert consensus, policy statements, and randomized controlled trials were included. Methodological quality was appraised using the Appraisal of Guidelines for Research & Evaluation II (AGREE Ⅱ) instrument, Joanna Briggs Institute (JBI) checklists, and the Critical Appraisal for Summaries of Evidence (CASE) tool, with evidence graded using the JBI Levels of Evidence and Grades of Recommendation system. Literature screening, quality appraisal, and evidence extraction were independently performed by two researchers. A total of 49 publications were included. Thirty-eight pieces of best evidence were synthesized across eleven domains: general principles, non-nutritive sucking, sweet-tasting solutions, breastfeeding, kangaroo mother care or skin-to-skin contact, facilitated tucking or flexed positioning, white noise, music intervention, maternal voice stimulation, breast milk odor, and combined non-pharmacological interventions. This study provides a synthesized evidence base for non-pharmacological management of procedural pain in NICU preterm infants. The findings may inform the development of standardized pain management protocols and facilitate the translation of evidence into clinical practice. Limitations include the absence of systematic stratified analyses across all gestational age subgroups and potential language bias, as only English and Chinese publications were included.
SN - 2224-4336
SN - 2224-4344
ER -