Document Detail

Nonpharmacological management of procedural pain in infants and young children: an abridged Cochrane review.
MedLine Citation:
PMID:  22059204     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acute pain and distress during medical procedures are commonplace for young children.
OBJECTIVE: To assess the efficacy of nonpharmacological interventions for acute procedural pain in children up to three years of age.
METHODS: Study inclusion criteria were: participants <3 years of age, involved in a randomized controlled or crossover trial, and use of a 'no treatment' control group (51 studies; n=3396). Additional studies meeting all criteria except for study design (eg, use of active control group) were qualitatively described (n=20).
RESULTS: For every intervention, data were analyzed separately according to age group (preterm-born, term-born neonate and older infant ⁄ young child) and type of pain response (pain reactivity, immediate pain-related regulation). The largest standardized mean differences (SMD) for pain reactivity were as follows: sucking-related interventions (preterm: -0.42 [95% CI -0.68 to -0.15]; neonate -1.45 [CI -2.34 to -0.57]), kangaroo care (preterm -1.12 [95% CI -2.04 to -0.21]), and swaddling ⁄ facilitated tucking (preterm -0.97 [95% CI -1.63 to -0.31]). For immediate pain-related regulation, the largest SMDs were: sucking-related interventions (preterm -0.38 [95% CI -0.59 to -0.17]; neonate -0.90 [CI -1.54 to -0.25]), kangaroo care 0.77 (95% CI -1.50 to -0.03]), swaddling ⁄ facilitated tucking (preterm -0.75 [95% CI -1.14 to -0.36]), and rocking ⁄ holding (neonate -0.75 [95% CI -1.20 to -0.30]). The presence of significant heterogeneity limited confidence in nonsignificant findings for certain other analyses.
CONCLUSIONS: Although a number of nonpharmacological treatments have sufficient evidence supporting their efficacy with preterm infants and healthy neonates, no treatments had sufficient evidence to support efficacy with healthy older infants ⁄ young children.
Rebecca Pillai Riddell; Nicole Racine; Kara Turcotte; Lindsay Uman; Rachel Horton; Laila Din Osmun; Sara Ahola Kohut; Jessica Hillgrove-Stuart; Bonnie Stevens; Diana Lisi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur     Volume:  16     ISSN:  1203-6765     ISO Abbreviation:  Pain Res Manag     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-11-07     Completed Date:  2011-12-16     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9612504     Medline TA:  Pain Res Manag     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  321-30     Citation Subset:  IM    
Department of Psychology, York University, Toronto, Ontario, Canada.
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MeSH Terms
Child, Preschool
Cross-Over Studies
Databases, Factual / statistics & numerical data
Pain Management / methods*
Randomized Controlled Trials as Topic
Grant Support
//Canadian Institutes of Health Research
Comment In:
Pain Res Manag. 2011 Sep-Oct;16(5):320   [PMID:  22059203 ]

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