Best evidence summary on non-pharmacological management of procedural pain in NICU preterm infants: an evidence synthesis and overview of reviews
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Background: 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. Methods: 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. Results: 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. Conclusions: 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.
Source: Translational Pediatrics
Authors: Fenfen Lan, Lin Li, Zhaohua Huo, Yuanyuan Wang, Juan Liu
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223321498