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Updated: Dec 13, 2025
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Published on: February 9, 2024
Systematic review and meta-analysis of olfactive stimulation interventions to manage procedural pain in preterm and
Gwenaëlle De Clifford-Faugere1, Andréane Lavallée2, Christelle Khadra2
1Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada; CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada; Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille, France.
Insights
Olfactive stimulation using familiar scents effectively reduces pain responses in neonates during medical procedures. This intervention shows promise for improving pain management in newborns, though further research is needed.
Area of Science:
- Neonatal intensive care
- Pain management
- Sensory interventions
Background:
- Neonates in intensive care units experience significant procedural pain.
- Inadequate pain management can negatively impact infant development.
- Limited effective pain relief options exist for neonates.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of olfactive stimulation on neonatal pain responses.
- To assess the impact of familiar odors on pain reactivity and regulation in infants.
Main Methods:
- Systematic review and meta-analysis of published studies.
- Comprehensive electronic database search (PubMed, MEDLINE, Embase, etc.) up to August 2019.
- Independent review of study selection, data extraction, and risk of bias assessment.
Main Results:
- Olfactive stimulation with familiar odors significantly reduced pain reactivity and improved pain regulation in neonates.
- Interventions decreased crying duration and improved physiological measures like heart rate and oxygen saturation.
- No adverse events were reported during the use of olfactive stimulation.
Conclusions:
- Olfactive stimulation is a potentially effective, non-invasive method for managing neonatal procedural pain.
- Evidence quality is low to very low, necessitating more rigorous trials.
- Further research with larger sample sizes is required to confirm efficacy and understand underlying mechanisms.
Background:
Preterm and full-term neonates undergo many painful procedures during their hospitalization in the neonatal intensive care unit. Unrelieved and repeated pain can have important repercussions on their motor and intellectual development. Still, pain management interventions are limited for neonates.
Objective:
This systematic review aimed to evaluate the effectiveness of olfactive stimulation interventions on the pain response of preterm and full-term infants during painful procedures.
Design:
Systematic review and meta-analysis.
Data Sources:
An electronic search was conducted from inception to August 2019 in PubMed, MEDLINE, Embase, CINAHL, PsycINFO, Web of Sciences, CENTRAL, Scopus and ProQuest.
Review Methods:
Study selection, data extraction, assessment of risk of bias and quality of evidence were performed by two independent reviewers.
Results:
3311 studies were screened. Of the 14 studies included studies (n = 1028 infants), results from 10 were combined in meta-analysis. The latter demonstrated that olfactive stimulation interventions using a familiar odor were effective compared to standard care on pain reactivity (SMD -0.69; 95% CI -0.93 to -0.44; I2 = 20%, p < 0.00001), pain regulation (SMD -0.40; 95% CI -0.66 to -0.14; I2 = 13%, p = 0.002), crying duration during (SMD -0.42; 95% CI -0.73 to -0.10; I2 = 47%, p = 0.009) and after the procedure (SMD -0.37; 95% CI -0.68 to -0.07; I2 = 0%, p = 0.01), heart rate after the procedure (MD -3.87; 95% CI -7.36 to -0.38; I2 = 99%, p = 0.03), oxygen saturation during (MD -0.47; 95% CI -0.86 to -0.08; I2 = 91%, p = 0.02) and after the procedure (MD -0.56; 95% CI -0.99 to -0.13; I2 = 99%, p = 0.01). No adverse event was reported.
Conclusion:
These findings are based on low to very low quality of evidence limiting our confidence in effect estimates. More rigorous trials with a larger sample size are needed to enhance the comprehension of the mechanisms underlying olfactive stimulation interventions and the interventions' efficacy.
