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Wróblewska-Seniuk K, Lenells M, Prescott MG, Fiander M, Soll R, Bruschettini M. Multisensory stimulation for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev 2024; 7:CD016073. [PMID: 38989978 PMCID: PMC11238622 DOI: 10.1002/14651858.cd016073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of multisensory stimulation compared to any single sensory intervention or standard care for physical and neurological development in preterm infants.
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Affiliation(s)
| | - Mikaela Lenells
- Women and Children's Health, Karolinska Institute, Stockholm, Sweden
- FoUU, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Roger Soll
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Matteo Bruschettini
- Cochrane Sweden, Department of Research and Education, Lund University, Skåne University Hospital, Lund, Sweden
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Ullsten A, Campbell-Yeo M, Eriksson M. Parent-led neonatal pain management-a narrative review and update of research and practices. FRONTIERS IN PAIN RESEARCH 2024; 5:1375868. [PMID: 38689885 PMCID: PMC11058235 DOI: 10.3389/fpain.2024.1375868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Research related to parent-led neonatal pain management is increasing, as is the clinical implementation. Skin-to-skin contact, breastfeeding and parents' vocalizations are examples of pain reducing methods that give parents an opportunity to protect their infant from harm while alleviating their anxiety and developing their parenting skills. Methods In this paper we will provide a narrative review and describe the current research about parent-led neonatal pain management. Based on this we will discuss clinical challenges, implementation strategies and implications for future research. Results Parents express great readiness to embrace opportunities to increase their self-efficacy in their ability to address infant pain. Parent-led pain-reducing methods are effective, feasible, cost-effective, culturally sensitive, and can be individualized and tailored to both the parent's and infant's needs. Both barriers and facilitators of parent-led pain care have been studied in research highlighting structural, organizational, educational, and intra- and interpersonal aspects. For example, health care professionals' attitudes and beliefs on parent-led methods, and their concern that parental presence during a procedure increases staff anxiety. On the other hand, the presence of a local pain champion whose duty is to facilitate the adoption of pain control measures and actively promote parent-professional collaboration, is crucial for culture change in neonatal pain management and nurses have a key role in this change. The knowledge-to-practice gap in parent-led management of infants' procedure-related pain highlight the need for broader educational applications and collaborative professional, parental and research initiatives to facilitate practice change. Conclusion Parent-led neonatal pain management is more than simply a humane and compassionate thing to do. The inclusion of parent-led pain care has been scientifically proven to be one of the most effective ways to reduce pain associated with repeated painful procedures in early life and parents report a desire to participate. Focus on enablers across interprofessional, organizational and structural levels and implementation of recommended pediatric pain guidelines can support the provision of optimal evidence-based family-centered neonatal pain management.
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Affiliation(s)
- Alexandra Ullsten
- Center for Clinical Research and Education, Region Värmland, Karlstad, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- MOM-LINC Lab, IWK Health Halifax, Halifax, NS, Canada
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Pillai Riddell RR, Bucsea O, Shiff I, Chow C, Gennis HG, Badovinac S, DiLorenzo-Klas M, Racine NM, Ahola Kohut S, Lisi D, Turcotte K, Stevens B, Uman LS. Non-pharmacological management of infant and young child procedural pain. Cochrane Database Syst Rev 2023; 6:CD006275. [PMID: 37314064 PMCID: PMC10265939 DOI: 10.1002/14651858.cd006275.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite evidence of the long-term implications of unrelieved pain during infancy, it is evident that infant pain is still under-managed and unmanaged. Inadequately managed pain in infancy, a period of exponential development, can have implications across the lifespan. Therefore, a comprehensive and systematic review of pain management strategies is integral to appropriate infant pain management. This is an update of a previously published review update in the Cochrane Database of Systematic Reviews (2015, Issue 12) of the same title. OBJECTIVES To assess the efficacy and adverse events of non-pharmacological interventions for infant and child (aged up to three years) acute pain, excluding kangaroo care, sucrose, breastfeeding/breast milk, and music. SEARCH METHODS For this update, we searched CENTRAL, MEDLINE-Ovid platform, EMBASE-OVID platform, PsycINFO-OVID platform, CINAHL-EBSCO platform and trial registration websites (ClinicalTrials.gov; International Clinical Trials Registry Platform) (March 2015 to October 2020). An update search was completed in July 2022, but studies identified at this point were added to 'Awaiting classification' for a future update. We also searched reference lists and contacted researchers via electronic list-serves. We incorporated 76 new studies into the review. SELECTION CRITERIA: Participants included infants from birth to three years in randomised controlled trials (RCTs) or cross-over RCTs that had a no-treatment control comparison. Studies were eligible for inclusion in the analysis if they compared a non-pharmacological pain management strategy to a no-treatment control group (15 different strategies). In addition, we also analysed studies when the unique effect of adding a non-pharmacological pain management strategy onto another pain management strategy could be assessed (i.e. additive effects on a sweet solution, non-nutritive sucking, or swaddling) (three strategies). The eligible control groups for these additive studies were sweet solution only, non-nutritive sucking only, or swaddling only, respectively. Finally, we qualitatively described six interventions that met the eligibility criteria for inclusion in the review, but not in the analysis. DATA COLLECTION AND ANALYSIS: The outcomes assessed in the review were pain response (reactivity and regulation) and adverse events. The level of certainty in the evidence and risk of bias were based on the Cochrane risk of bias tool and the GRADE approach. We analysed the standardised mean difference (SMD) using the generic inverse variance method to determine effect sizes. MAIN RESULTS: We included total of 138 studies (11,058 participants), which includes an additional 76 new studies for this update. Of these 138 studies, we analysed 115 (9048 participants) and described 23 (2010 participants) qualitatively. We described qualitatively studies that could not be meta-analysed due to being the only studies in their category or statistical reporting issues. We report the results of the 138 included studies here. An SMD effect size of 0.2 represents a small effect, 0.5 a moderate effect, and 0.8 a large effect. The thresholds for the I2 interpretation were established as follows: not important (0% to 40%); moderate heterogeneity (30% to 60%); substantial heterogeneity (50% to 90%); considerable heterogeneity (75% to 100%). The most commonly studied acute procedures were heel sticks (63 studies) and needlestick procedures for the purposes of vaccines/vitamins (35 studies). We judged most studies to have high risk of bias (103 out of 138), with the most common methodological concerns relating to blinding of personnel and outcome assessors. Pain responses were examined during two separate pain phases: pain reactivity (within the first 30 seconds after the acutely painful stimulus) and immediate pain regulation (after the first 30 seconds following the acutely painful stimulus). We report below the strategies with the strongest evidence base for each age group. In preterm born neonates, non-nutritive sucking may reduce pain reactivity (SMD -0.57, 95% confidence interval (CI) -1.03 to -0.11, moderate effect; I2 = 93%, considerable heterogeneity) and improve immediate pain regulation (SMD -0.61, 95% CI -0.95 to -0.27, moderate effect; I2 = 81%, considerable heterogeneity), based on very low-certainty evidence. Facilitated tucking may also reduce pain reactivity (SMD -1.01, 95% CI -1.44 to -0.58, large effect; I2 = 93%, considerable heterogeneity) and improve immediate pain regulation (SMD -0.59, 95% CI -0.92 to -0.26, moderate effect; I2 = 87%, considerable heterogeneity); however, this is also based on very low-certainty evidence. While swaddling likely does not reduce pain reactivity in preterm neonates (SMD -0.60, 95% CI -1.23 to 0.04, no effect; I2 = 91%, considerable heterogeneity), it has been shown to possibly improve immediate pain regulation (SMD -1.21, 95% CI -2.05 to -0.38, large effect; I2 = 89%, considerable heterogeneity), based on very low-certainty evidence. In full-term born neonates, non-nutritive sucking may reduce pain reactivity (SMD -1.13, 95% CI -1.57 to -0.68, large effect; I2 = 82%, considerable heterogeneity) and improve immediate pain regulation (SMD -1.49, 95% CI -2.20 to -0.78, large effect; I2 = 92%, considerable heterogeneity), based on very low-certainty evidence. In full-term born older infants, structured parent involvement was the intervention most studied. Results showed that this intervention has little to no effect in reducing pain reactivity (SMD -0.18, 95% CI -0.40 to 0.03, no effect; I2 = 46%, moderate heterogeneity) or improving immediate pain regulation (SMD -0.09, 95% CI -0.40 to 0.21, no effect; I2 = 74%, substantial heterogeneity), based on low- to moderate-certainty evidence. Of these five interventions most studied, only two studies observed adverse events, specifically vomiting (one preterm neonate) and desaturation (one full-term neonate hospitalised in the NICU) following the non-nutritive sucking intervention. The presence of considerable heterogeneity limited our confidence in the findings for certain analyses, as did the preponderance of evidence of very low to low certainty based on GRADE judgements. AUTHORS' CONCLUSIONS Overall, non-nutritive sucking, facilitated tucking, and swaddling may reduce pain behaviours in preterm born neonates. Non-nutritive sucking may also reduce pain behaviours in full-term neonates. No interventions based on a substantial body of evidence showed promise in reducing pain behaviours in older infants. Most analyses were based on very low- or low-certainty grades of evidence and none were based on high-certainty evidence. Therefore, the lack of confidence in the evidence would require further research before we could draw a definitive conclusion.
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Affiliation(s)
| | - Oana Bucsea
- Department of Psychology, York University, Toronto, Canada
| | - Ilana Shiff
- Department of Psychology, York University, Toronto, Canada
| | - Cheryl Chow
- Department of Psychology, York University, Toronto, Canada
| | | | | | | | - Nicole M Racine
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Sara Ahola Kohut
- Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada
| | - Diana Lisi
- Department of Psychology, University of British Columbia Okanagan, Kelowna, Canada
| | - Kara Turcotte
- Department of Psychology, University of British Columbia Okanagan, Kelowna, Canada
| | - Bonnie Stevens
- Nursing Research, The Hospital for Sick Children, Toronto, Canada
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Sharma N, Samuel AJ. A Systematic Review of Multisensory Stimulation on Procedural Pain Among Preterm Neonates. Pediatr Phys Ther 2023; Publish Ahead of Print:00001577-990000000-00060. [PMID: 37276195 DOI: 10.1097/pep.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE This systematic review aims to evaluate the quality of studies and synthesize the literature on multisensory stimulation (MSS) on procedural pain among hospitalized preterm neonates. SUMMARY OF KEY POINTS Search strategies were applied to PubMed/Medline, CINAHL, SCOPUS, and PEDro. A total of 414 studies were identified, 104 were screened, and 4 were included. Two independent reviewers extracted data from identified studies that were synthesized qualitatively and quantitatively. CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE There is strong evidence of MSS in decreasing procedural pain, but additional research is needed to identify the beneficial effects of MSS with a standardized protocol to promote good clinical practice in neonatal intensive care settings. WHAT THIS ADDS TO THE EVIDENCE High-quality evidence supports beneficial effects of MSS, but standardization of the MSS protocol and its administration needs to be established.
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Affiliation(s)
- Neha Sharma
- Department of Pediatric and Neonatal Physiotherapy (Ms Sharma and Dr Samuel), Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India; Yenepoya Physiotherapy College (Dr Samuel), Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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Pados BF. State of the Science on the Benefits of Human Milk for Hospitalized, Vulnerable Neonates. Nurs Womens Health 2023; 27:121-140. [PMID: 36871597 DOI: 10.1016/j.nwh.2023.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/16/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023]
Abstract
Research on human milk has increased dramatically in recent years. The purpose of this review is to describe the literature on the health benefits of human milk for hospitalized, vulnerable neonates. PubMed, CINAHL, and Embase were searched for research articles reporting the health outcomes of hospitalized neonates who were exposed to human milk. Human milk, particularly a mother's own milk, has the potential to reduce the risk of death and the risk and severity of necrotizing enterocolitis, infection, retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular hemorrhage, kidney disease, and liver disease. Dose and timing of human milk is important, with more human milk and earlier introduction having a greater impact on health. When a mother's own milk is not available, donor human milk provides benefits over infant formula.
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Astuti SCD, Sari RT. The Effect of Using Endorphin Massage for Decreasing Pain at First Stage in Normal Labor. JURNAL INFO KESEHATAN 2022. [DOI: 10.31965/infokes.vol20.iss2.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Labor pain is a subjective experience of physical sensations associated with uterine contractions, dilation, thinning cervix and fetal descent during labor. To resolve the pain of labor, it has been implemented in a nonpharmacological method which is endorphin massage, in understanding endorphin massage for pressing pain in the first stage, in an active phase of normal multiparous mothers' deliveries. This research aims to research endorphin massage's influence on suppressing pain during the active phase of normal labor of multiparous mothers. This study is quasi-experimental with a cross-sectional approach. The study population of all women giving birth administered the purposive sampling data capture techniques, and it was obtained 132 multiparous mothers with normal labor in the observation sheet. Data were examined by administering a T-test. The majority of the pain intensity in the first stage of active phase multiparous mothers with normal labor, before the breath relaxation, is severe, with up to 49% experiencing severe pain. The majority of the percentage of moderate pain in the first stage of active phase multiparous mothers with normal labor, after breath relaxation, is as high as 42%. Meanwhile, the pain intensity of the first stage in active phase multiparous mothers with normal labor, prior to endorphin massage, is as high as 73.3%. Pain intensity of the first stage in active phase multiparous mothers normal labor after endorphin massage, the majority of the percentage is moderate pain up to 53.3%. Statistical test results obtained p-value is 0.004 endorphin massage. In conclusion, there is an effect of breath relaxation on the intensity of pain during normal labor in multiparous mothers. Furthermore, researchers can do a combination of endorpine massage with other treatments to treat pain during the I active phase of labor and pain intensity checks can be done by testing cortisol levels.
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Sharma N, Samuel AJ. Multisensory stimulation as a non-pharmacological intervention for neonates undergoing painful procedures: A scoping review. J Neonatal Perinatal Med 2022; 15:677-687. [PMID: 36189504 DOI: 10.3233/npm-221087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM The aim of this review is to identify available evidence on MSS practices as a pain-relieving intervention among neonates undergoing a repetitive painful procedure. METHODS Searches were performed in the following databases: PubMed/ MEDLINE, SCOPUS, CINAHL, and the physiotherapy evidence database (PEDro). A total of eight studies were identified, among them; studies related to MSS in relieving neonatal procedural pain were conducted only in three countries only. RESULTS Data collected from the identified studies were extracted by two independent reviewers, and were synthesized quantitatively, and qualitatively. Eight studies involving six hundred and eighty-six neonates in three countries were identified in the search. Among them, six were randomized controlled trials, and two were observational studies. The study results highlighted that implementation of MSS as a non-pharmacological pain-relieving intervention follows a similar protocol among the reviewed articles, but varies by who administers MSS (Physiotherapists/ Nurses/Mothers) in neonates undergoing repetitive painful procedures. INTERPRETATION Standardized MSS protocol should be followed globally along with its implementation for reducing procedural pain among neonates and also to promote good clinical practice in neonatal intensive care unit (NICU) settings. Future research could determine the effects of standardized MSS protocol either with or without other non-pharmacological interventions among neonates undergoing painful procedures.
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Affiliation(s)
- N Sharma
- Department of Paediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - A J Samuel
- Department of Paediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India.,Yenepoya Physiotherapy College, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
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Nist MD, Robinson A, Harrison TM, Pickler RH. An integrative review of clinician-administered comforting touch interventions and acute stress responses of preterm infants. J Pediatr Nurs 2022; 67:e113-e122. [PMID: 36137912 DOI: 10.1016/j.pedn.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
PROBLEM Preterm infants experience numerous stressors in the neonatal intensive care unit. Non-pharmacological interventions, including maternal comforting touch, reduce stress responses of preterm infants; however, the effects of clinician-administered comforting touch are unclear. The purpose of this integrative review was to synthesize findings from clinical trials to determine the effect of clinician-administered comforting touch on preterm infants' acute stress responses. ELIGIBILITY CRITERIA Eligible clinical trials were published in English between 2001 and October 2021 and reported effects of clinician-administered comforting touch on acute stress responses in preterm infants. SAMPLE Thirty clinical trials were included. RESULTS Researchers tested the effect of comforting static touch, massage, massage with kinesthetic stimulation, sensorial saturation, and Yakson. There was significant heterogeneity in study design, comparison condition, and context of intervention delivery. Results varied; some studies demonstrated efficacy of comforting touch in reducing acute stress responses and others showed no effect. Generally, comforting touch provided during stressful procedures was associated with lower stress responses compared to standard care and was an effective adjunct to other stress management strategies. However, comforting touch alone was insufficient for managing pain, especially during skin-breaking procedures. CONCLUSIONS While comforting touch may be a useful part of stress management plans for preterm infants, additional research is needed to determine when comforting touch is appropriate and effective. IMPLICATIONS Comforting touch is beneficial to preterm infants and should be provided for stress management. For highly intrusive or painful procedures, comforting touch can be provided as part of a comprehensive stress management plan.
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Affiliation(s)
- Marliese Dion Nist
- The Ohio State University College of Nursing, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Audrey Robinson
- The Ohio State University College of Nursing, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Tondi M Harrison
- The Ohio State University College of Nursing, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Rita H Pickler
- The Ohio State University College of Nursing, 1585 Neil Avenue, Columbus, OH 43210, USA.
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Çamur Z, Erdoğan Ç. The Effects of Breastfeeding and Breast Milk Taste or Smell on Mitigating Painful Procedures in Newborns: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Breastfeed Med 2022; 17:793-804. [PMID: 36126292 DOI: 10.1089/bfm.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Newborns hospitalized in the neonatal intensive care unit are exposed to an average of 10 painful procedures per day. The pain-related experiences of babies can be associated with neurodevelopmental disorders that may affect them throughout their lives. Aim/Objective: The purpose of this study was to summarize and analyze the analgesic effects of breastfeeding alone, expressed breast milk, and breast milk smell on newborns and present stronger evidence that would guide clinical practice and future studies. Methods: We searched articles published between 2000 and 2021 on the CINAHL, Cochrane Central, Web of Science, PubMed, Scopus, Science Direct, Eric, and OVID databases. Nine full texts that met the inclusion criteria (Population: Newborn term or preterm babies, Intervention: Implementing breastfeeding, expressed breast milk, breast milk taste, or breast milk smell alone or in combinations in the intervention groups, Comparison: Making comparisons to the standard care of the clinic where the study was conducted, Outcomes: Including at least one pain-related criterion, Study design: Randomized-controlled trials) were included in this systematic review and meta-analysis. The nine randomized controlled studies in total that were included in this study were carried out between 2004 and 2021 with 33-130 newborns in their samples. The total number of newborns was 720. The effects of these interventions on pain scale scores, heart rate, and oxygen saturation were also analyzed. Results: According to the results of this systematic review and meta-analysis, the breastfeeding, breast milk smell, or breast milk taste interventions had large effect sizes in terms of pain management during and after the procedures. These interventions had medium effect sizes in terms of heart rate during the procedures and large effect sizes after the procedures. In terms of oxygen saturation, they had large effect sizes during the procedures and medium effect sizes after the procedures. Conclusion: Breastfeeding and breast milk interventions are significantly effective nonpharmacological alternatives for painful procedures.
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Affiliation(s)
- Zühal Çamur
- Midwifery Department, Karabük University Faculty of Health Sciences, Karabük, Turkey
| | - Çiğdem Erdoğan
- Department of Pediatric Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Turkey
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Embarek-Hernández M, Güeita-Rodríguez J, Molina-Rueda F. Multisensory stimulation to promote feeding and psychomotor development in preterm infants: A systematic review. Pediatr Neonatol 2022; 63:452-461. [PMID: 35934665 DOI: 10.1016/j.pedneo.2022.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/14/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Sensory stimulation is an intervention that, through peripheral stimuli, can facilitate brain organization, due to neuronal plasticity and cortical reorganization. The objective of this study was to evaluate the evidence about the effects of a multisensory stimulation program, applied on preterm infants, compared to any intervention or standard care, to improve feeding behaviour, and psychomotor development. METHODS The data sources included Medline (pubmed, EBSCO), Scopus and Web Of Science. The studies were randomized clinical trials published between 2015 and 2021 that analyzed multisensory stimulation interventions in preterm infants born less than 37 weeks of pregnancy. RESULTS Nine articles were identified, involving 545 preterm infants between 25 and 37 weeks of pregnancy. The studies applied different combinations of sensory stimulation. These interventions were related to a better time to achieve full oral feeding and higher consumption of human milk at discharge, better psychomotor development and visual function. All studies scored 6 or higher on the PEDro scale meaning good quality. CONCLUSION Multisensory stimulation in preterm infants may improve feeding, psychomotor development, and visual function.
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Affiliation(s)
| | - Javier Güeita-Rodríguez
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University 28922, Madrid, Spain.
| | - Francisco Molina-Rueda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University 28922, Madrid, Spain
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Puengsurin D, Meepong R, Rotpenpian N, Wanasuntronwong A, Surarit R. Sucrose alleviates capsaicin-induced tongue burning: An in vivo study. J Clin Exp Dent 2022; 14:e541-e545. [PMID: 35912025 PMCID: PMC9328490 DOI: 10.4317/jced.58911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Spicy foods are flavorful and stimulate salivation, which is beneficial for individuals with poor appetite. They are also ubiquitous in many regional cuisines, but the chemical compounds in such foods, especially capsaicin from chili peppers, can cause tissue inflammation and generate intolerable burning pain in the oral cavity.
Material and Methods To identify a potential method to reduce capsaicin-induced burning pain without influencing food flavor, we tested the effects of mouth rinsing with various concentrations of sucrose. Inclusion criteria were good general and oral health, while exclusion criteria were poor baseline smell or taste, capsaicin allergy, and current orofacial pain complaints. To define an appropriate capsaicin dose, participants placed filter paper strips impregnated with 0.003%–0.3% capsaicin on the tip of the tongue and rated burning sensation by visual analog scale (VAS) score.
Results A 0.1% capsaicin solution induced tongue burning in the midrange (VAS = 6.33 ± 0.52) and so was used for subsequent tests. We then examined the efficacy concentration of sucrose for reducing tongue burning by recording VAS scores at multiple time points following a 15-s oral rinse with various aqueous sucrose solutions (5%, 10%, and 20%), milk, or pure water (control) after 0.1% capsaicin application. Scores were compared at each time point by one-way ANOVA with post hoc Dunnett’s tests. A 15-s rinse with 20% sucrose significantly alleviated burning pain compared to water rinse at 45, 60, 120, and 180 s after capsaicin exposure.
Conclusions Thus, periodic rinsing with 20% aqueous sucrose may help promote spicy food consumption among individuals with poor appetite. Key words:Capsaicin, sucrose, burning sensation.
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Affiliation(s)
- Duangchewan Puengsurin
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Rittinarong Meepong
- Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand
| | - Nattapon Rotpenpian
- Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Aree Wanasuntronwong
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Rudee Surarit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
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Multisensory Stimulation and Soft Tissue Therapy on Pain and Neurodevelopment Among Preterm Neonates. Pediatr Phys Ther 2022; 34:277-282. [PMID: 35385466 DOI: 10.1097/pep.0000000000000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the combined effects of multisensory stimulation (MSS) and soft tissue therapy (STT) in managing procedural pain and promoting neurodevelopment in neonates undergoing repetitive painful procedures during their neonatal intensive care unit (NICU) stay. METHODS Total of 104 preterm neonates admitted in NICU will be recruited for this trial. The intervention will be given for 5 consecutive days to both the groups. Experimental group will receive both MSS and STT; control group will receive routine NICU care. The premature infant pain profile and Neonatal Pain, Agitation, and Sedation Scale will be used for assessing procedural pain, and Infant Neurological International Battery and Premie-Neuro will be used for assessing neurodevelopmental maturity. Relevant parametric or nonparametric test will be used to analyze the data for all outcomes. DISCUSSION This is a study protocol analyzing the combined effects of nonpharmacological interventions (MSS and STT) in preterm neonates.
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Lin CH, Liaw JJ, Chen YT, Yin T, Yang L, Lan HY. Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031240. [PMID: 35162263 PMCID: PMC8834920 DOI: 10.3390/ijerph19031240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to evaluate the efficacy of breast milk odor either alone or in combination with breast milk taste (via syringe-feeding) to alleviate neonates’ biobehavioral responses to pain during heel-prick procedures. This prospective randomized controlled trial recruited 114 neonates by convenience sampling from a newborn unit of a medical center in Taiwan. Neonates were randomly assigned to three groups: control (gentle touch + human voice), control + breast milk odor, and control + breast milk odor + breast milk taste. Heart rate, oxygen saturation, and voice recordings of crying were measured across heel-prick procedures: baseline, no stimuli (stage 0); during heel prick (Stages 1–4); and recovery (Stages 5–10). Generalized estimating equations and Kaplan–Meier survival analysis compared differences in changes between groups for heart rate, oxygen saturation, and time to crying cessation. Changes in mean heart rate and oxygen saturation in neonates receiving breast milk odor or breast milk odor + breast milk taste were significantly less than those at the corresponding stage for the control group. Among neonates receiving breast milk odor or breast milk odor + breast milk taste, hazard rate ratios for crying cessation were 3.016 and 6.466, respectively. Mother’s breast milk olfactory and gustatory interventions could stabilize the biobehavioral responses to pain during heel prick procedures in neonates.
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Affiliation(s)
- Chiao-Hsuan Lin
- Department of Nursing, Tri-Service General Hospital, Taipei 11490, Taiwan; (C.-H.L.); (T.Y.)
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yu-Ting Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Ti Yin
- Department of Nursing, Tri-Service General Hospital, Taipei 11490, Taiwan; (C.-H.L.); (T.Y.)
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Luke Yang
- Department of Social Work, Hsuan Chuang University, Taipei 30092, Taiwan;
| | - Hsiang-Yun Lan
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan;
- Correspondence:
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