What is the influence of non-pharmacologic pain management strategies on pain response in neonates at risk for neonatal opioid withdrawal?
This review will consider studies that include any full term (born > 37 weeks gestational age [GA]) and preterm (born less than 36 6/7 weeks GA) neonates (< 30 days of age) exposed to acute painful procedures. Neonates cared for in both perinatal units and Neonatal Intensive Care Units (NICUs) or special care nurseries will be all be considered eligible.
(1) Parent-infant skin-to-skin contact (neonate wearing no more than a diaper in full ventral skin contact with another person during a painful procedure); (2) breastfeeding (neonate latched to breast and actively sucking during painful procedure) or expressed breastmilk (provided orally prior to painful procedure).
(1) Placebo or no-treatment; (2) Non-nutritive sucking (sucking on a pacifier or gloved finger throughout the painful procedure); (3) Positioning (neonate contained using blanket or facilitated tucking during painful procedure)
Pain response to an invasive/pain-inducing acute procedure and/or recovery from an invasive/pain-inducing acute procedure measured using one or more of the following outcomes: (1) Behavioural pain indicators (e.g., audible cry, pain-related facial actions, limb movements); (2) Physiologic pain indicators (e.g., heart rate, respiratory rate, oxygen saturation, neurophysiologic indicators, hormonal indicators); (3) Validated composite pain scores (e.g., Premature Infant Pain Profile [PIPP] or Premature Infant Pain Profile-Revised [PIPP-R], COMFORT scale, Neonatal Infant Pain Scale [NIPS], Neonatal Pain, Agitation, and Sedation Scale [NPASS], Douleur Aiguë du Nouveau-né [DAN], Behavioral Indicators of Infant Pain [BIIP]).