Background: The burden of pain in newborns has been investigated in several studies, but little is known about the appropriateness and effectiveness of using pain scales according to the specific type of pain or the condition of the infant. Our purpose was to conduct a meta-analysis to assess and report on the effectiveness of the used procedural pain scale to measure pain in a child over 0-1years reflecting that by using the non-pharmacological interventions in pain reduction in randomized trials.
Methods: A systematic search was performed up to October 2021 in PubMed and Cochrane Library The current review enrolled randomized clinical trials (RCTs). It was also conducted according to PRISMA guidelines. Cochrane's risk of bias assessment was used to assess the studies' quality and risk of bias. Meta-analyses were performed by calculating the standardized mean difference (SMD) at a 95% confidence interval (CI) using Review Manager Software
Results: 50 trials were found 8 trials were included in this meta-analysis. Most of the studies related to procedural pain (heel lance and vaccination), Three validated pain scales were used in all trials (neonatal infant pain scale NIPS, premature infant pain profile PIPP, AND neonatal pain, agitation, and sedation scale NPASS. The Meta-analysis showed significant effect of non- pharmacological interventions (swaddling, mother holding, sucrose) in pain reduction compared with control group (SMD 1.2, 95% CI -1.88 to -.52, P =0.0005), I` = 95%, P> 0.00001. The 8 studies with
918 infant’s participants entered into analysis used effective pain scales (NIPS, PIPP, and NPASS) to measure procedural pain effectively
Conclusions: overall the non-pharmacological interventions show positively effect in pain reduction, these mean the pain scales that are used in studies appropriate to assess pain when measure procedural pain (heel lice, vaccination), however, there is no consistency about the best tool to use in children related to several factors.