Related Experiment Video
Updated: Jun 28, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
A review of systematic reviews on pain interventions in hospitalized infants
1The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada. janet.yamada@sickkids.ca
Insights
Effective pain management for hospitalized infants is crucial. High-quality systematic reviews support pharmacological and non-pharmacological interventions for procedural pain, guiding clinical practice.
Area of Science:
- Pediatric Pain Management
- Evidence-Based Practice in Neonatology
Background:
- Hospitalized infants frequently experience multiple, painful procedures.
- Current clinical guidelines often lack the highest quality evidence for procedural pain management.
Purpose of the Study:
- To critically appraise systematic reviews on procedural pain interventions for hospitalized infants.
- To identify the most effective pharmacological and non-pharmacological pain management strategies.
Main Methods:
- A structured review of systematic reviews and meta-analyses was performed.
- Searches included major databases (Cochrane, MEDLINE, EMBASE, CINAHL, PsycINFO).
- Methodological quality of reviews was assessed using a validated 7-point measure.
Main Results:
- 11 high-quality systematic reviews were included.
- Effective pharmacological interventions include premedication for intubation, dorsal penile nerve block, EMLA for circumcision, and sucrose for single procedures.
- Supported non-pharmacological interventions include non-nutritive sucking, swaddling, holding, and breastfeeding.
Conclusions:
- Evidence supports various pharmacological and non-pharmacological interventions for infant procedural pain.
- Further research is needed on combined interventions to optimize pain management strategies.
- High-quality evidence is essential for informed clinical decision-making in infant pain management.
Background:
Hospitalized infants undergo multiple, repeated painful procedures. Despite continued efforts to prevent procedural pain and improve pain management, clinical guidelines and standards frequently do not reflect the highest quality evidence from systematic reviews.
Objective:
To critically appraise all systematic reviews on the effectiveness of procedural pain interventions in hospitalized infants.
Methods:
A structured review was conducted on published systematic reviews and meta-analyses of pharmacological and nonpharmacological interventions of acute procedural pain in hospitalized infants. Searches were completed in the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL and PsycINFO. Two reviewers independently selected articles for review and rated the methodological quality of the included reviews using a validated seven-point quality assessment measure. Any discrepancies were resolved by a third reviewer.
Results:
Of 1469 potential systematic reviews on interventions for painful procedures in hospitalized infants, 11 high-quality reviews were included in the analysis. Pharmacological interventions supported by research evidence included premedication for intubation, dorsal penile nerve block and EMLA (AstraZeneca Canada, Inc) for circumcision, and sucrose for single painful procedures. Non-nutritive sucking, swaddling, holding, touching, positioning, facilitative tucking, breast feeding and supplemental breast milk were nonpharmacological interventions supported for procedural pain.
Conclusion:
There is a growing number of high-quality reviews supporting procedural pain management in infants. Ongoing research of single, repeated and combined pharmacological and nonpharmacological interventions is required to provide the highest quality evidence to clinicians for decision-making on optimal pain management.
