Comparative Efficacy of Interventions for Analgesia During Heel Prick in Newborn Infants - A Systematic Review and Network Meta-Analysis

Simple item page
dc.contributor.authorAbiramalatha, Thangarajen_US
dc.contributor.authorRamaswamy, Viraraghavan Vadakkencherryen_US
dc.contributor.authorAnne, Rajendra Prasaden_US
dc.contributor.authorAmuji, Nalinaen_US
dc.contributor.authorThinesh, Jayaramanen_US
dc.contributor.authorVenkateshwarlu, Vardhellien_US
dc.contributor.authorRao, Vadije Praveenen_US
dc.contributor.authorShaik, Nasreen Banuen_US
dc.contributor.authorPullattayil, Abdul Kareemen_US
dc.contributor.authorBalachander, Bharathien_US
dc.contributor.authorSivanandhan, Sindhuen_US
dc.contributor.authorKumar, Jogenderen_US
dc.contributor.authorGupta, Neerajen_US
dc.contributor.authorChawla, Deepaken_US
dc.contributor.authorKumar, Praveenen_US
dc.contributor.authorRao, Sumanen_US
dc.date.accessioned2025-05-09T10:00:42Z
dc.date.available2025-05-09T10:00:42Z
dc.date.issued2024-09
dc.description.abstractContext: Heel prick is one among the common painful procedures in neonates. We performed a systematic review and network meta- analysis (NMA) to compare the efficacy of different interventions for analgesia during heel prick in neonates. Evidence acquisition: Medline, Cochrane, Embase and CINAHL databases were searched from inception until February 2023. Randomized and quasi-randomized trials that evaluated different pharmacological and non-pharmacological interventions for analgesia during heel prick for neonates were included. Data from the included trials were extracted in duplicate. A NMA with a frequentist random-effects model was used for data synthesis. Certainty of evidence (CoE) was assessed using GRADE. We adhered to the PRISMA-NMA guidelines. Results: One-hundred-and-three trials comparing 51 different analgesic measures were included. Among the 38 interventions, for pain “during” heel prick, non-nutritive suckling (NNS) plus sucrose [SMD -3.15 (-2.62, -3.69)], followed by breastfeeding, glucose, expressed breast milk (EBM), sucrose, NNS and touch massage, had a high certainty of evidence (CoE) to reduce pain scores when compared to no intervention. Among the 23 interventions for pain at 30 seconds after heel-prick, moderate CoE was noted for facilitated tucking plus NNS plus music, glucose, NNS plus sucrose, sucrose plus swaddling, mother holding, EBM, sucrose and NNS. Conclusions: Oral sucrose 2 minutes before combined with NNS during the procedure, was the best intervention for reducing pain during heel prick. It also effectively reduced pain scores 30 seconds and 1 minute after the procedure. Other interventions with moderate to high CoE for a significant reduction in pain during and at 30 seconds after heel prick are oral sucrose, oral glucose, EBM and NNS. All these are low-cost and feasible interventions for most of the settings.en_US
dc.identifier.affiliationsNeonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, Tamil Nadu, Indiaen_US
dc.identifier.affiliationsAnkura Hospital for Women and Children, Hyderabad, Telangana, Indiaen_US
dc.identifier.affiliationsDepartment of Neonatology, Kasturba Medical College, Manipal, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, Indiaen_US
dc.identifier.affiliationsRainbow Children’s Hospital, Chennai, Tamil Nadu, Indiaen_US
dc.identifier.affiliationsThe Birthplace by Cloudnine Hospital, Hyderabad, Telangana, Indiaen_US
dc.identifier.affiliationsCloudnine Hospital, Hitech City, Hyderabad, Telangana, Indiaen_US
dc.identifier.affiliationsAnkura Hospital for Women and Children, Hyderabad, Telangana, Indiaen_US
dc.identifier.affiliationsHealth Sciences Librarian, Queen’s University, Kingston, Canadaen_US
dc.identifier.affiliationsDepartment of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, Indiaen_US
dc.identifier.affiliationsKauvery Hospital, Radial Road, Kovilambakkam, Chennai, Tamilnadu, Indiaen_US
dc.identifier.affiliationsNewborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Neonatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Indiaen_US
dc.identifier.affiliationsDepartment of Neonatology, Government Medical College Hospital, Chandigarh, Indiaen_US
dc.identifier.affiliationsNewborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Neonatology, St. Johns Medical College Hospital, Bengaluru, Karnataka, Indiaen_US
dc.identifier.citationAbiramalatha Thangaraj, Ramaswamy Viraraghavan Vadakkencherry, Anne Rajendra Prasad, Amuji Nalina, Thinesh Jayaraman, Venkateshwarlu Vardhelli, Rao Vadije Praveen, Shaik Nasreen Banu, Pullattayil Abdul Kareem, Balachander Bharathi, Sivanandhan Sindhu, Kumar Jogender, Gupta Neeraj, Chawla Deepak, Kumar Praveen, Rao Suman . Comparative Efficacy of Interventions for Analgesia During Heel Prick in Newborn Infants - A Systematic Review and Network Meta-Analysis. Indian Pediatrics. 2024 Sep; 61(9): 851-996en_US
dc.identifier.issn0974-7559
dc.identifier.issn0019-6061
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/245725
dc.languageenen_US
dc.publisherThe Indian Academy of Pediatricsen_US
dc.relation.issuenumber9en_US
dc.relation.volume61en_US
dc.source.urihttps://indianpediatrics.net/sep2024/851.pdfen_US
dc.subjectNeonatal analgesiaen_US
dc.subjectNon-pharmacological pain reliefen_US
dc.subjectPharmacological pain reliefen_US
dc.subjectProcedural painen_US
dc.titleComparative Efficacy of Interventions for Analgesia During Heel Prick in Newborn Infants - A Systematic Review and Network Meta-Analysisen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
ip2024v61n9p851.pdf
Size:
6.48 MB
Format:
Adobe Portable Document Format
Download
Collections
Indian Pediatrics