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Intervention strategies for white noise alleviating procedural pain in newborns: A systematic review
Xian Ye1, Jun-Qing Chen1, Ling-Li Zhu2
1Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
White noise effectively alleviates procedural pain in newborns. Recommended strategies include specific durations, volume levels (optimal 55 dB), and simulating intrauterine sounds for pain management.
Area of Science:
- Neonatal care
- Pain management
- Auditory interventions
Background:
- Procedural pain in newborns is a significant clinical concern.
- Effective non-pharmacological pain relief strategies are crucial for neonatal well-being.
Approach:
- Systematic review following PRISMA guidelines.
- Inclusion of 18 studies published before June 2022.
- Quality assessment using the Cochrane Handbook for Systematic Reviews of Interventions.
Key Points:
- Intervention parameters varied across studies, including duration, distance, volume, and music type.
- Duration significantly impacted white noise effectiveness.
- Optimal volume is suggested at 45-55 dB, with 55 dB being ideal.
Conclusions:
- Recommended intervention strategies: 1-3 min duration around procedures, distance based on clinical setting, volume at 45-55 dB, and intrauterine sound simulation.
- Further research is needed to optimize intervention strategies.
- This review provides evidence for using white noise to relieve procedural pain in newborns.
Aims And Objective:
To systematically evaluate the current intervention strategies of white noise alleviating procedural pain in newborns.
Methods:
This review was conducted following the PRISMA guideline. Seventeen databases National Guideline Clearinghouse, up to date, Clinical Evidence, BMJ best practice, Cochrane library, OVID, PubMed, Medline, EMBASE, Web of Science, CHINHAL, Medlive, China Biology Medicine disc, Chinese Clinical Trial Registry, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform were employed, and the studies about pain-relieving with white noise in newborns published before June 2022 was included. Quality of studies was evaluated by using the Cochrane Handbook for Systematic Reviews of Interventions.
Results:
18 studies were included, with sample sizes ranging from 32-296 cases. Intervention indices included duration, distance, volume, music type and outcome measure. Duration varies from study to study, from 5 min before to 5 min after the procedures. The distance was controlled at 10-60 cm, volume was controlled at 45-60 dB and music type was selected from Orhan Osman's album "Kolic" in most studies. Outcome measures included physiological indicators, neurophysiological indicators, behavioural indicators and pain score. Differences in duration leading to different white noise effects was found, but no studies have shown whether there is an effect of different volume, distance or music type.
Conclusions:
Based on this review, we recommend the following intervention strategies: the duration is set from 1 min before to 3 min after the procedures, the distance is decided according to the actual clinical situation, the volume is controlled at 45-55 dB (55 dB is optimal), the music type is selected to simulate intrauterine sounds, and outcome measures can choose physiological indicators, neurophysiological indictors, behavioural indicators and pain score depending on specific department and population. It is important to further explore the best intervention strategies.
Relevance To Clinical Practice:
In addition to providing a set of intervention strategies, this review could be used as evidence for relieving procedural pain in newborns.
Patient Or Public Contribution:
No Patient or Public Contribution. Data were obtained from others' literature.
