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Research progress on multisensory stimulation therapy for pain during retinopathy of prematurity screening
Chunlan Tao1, Chuan He2, Jinghua Tang1
1Department of Neonatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Insights
Multisensory stimulation (MSS) effectively manages pain during retinopathy of prematurity (ROP) screening. Combining auditory and tactile methods, like white noise with non-nutritive sucking, offers superior pain relief for premature infants.
Area of Science:
- Neonatal care
- Ophthalmology
- Pain management
Background:
- Retinopathy of prematurity (ROP) is a leading cause of vision impairment in premature infants.
- Increased survival rates in neonates have led to a higher incidence of ROP, necessitating regular screening.
- ROP screening procedures can cause significant pain, requiring effective, non-pharmacological management strategies.
Purpose of the Study:
- To review the evidence on multisensory stimulation (MSS) for pain management during ROP screening.
- To explore the operational definitions, analgesic mechanisms, and clinical efficacy of MSS interventions.
- To provide guidance for implementing MSS to minimize procedural pain in neonates.
Main Methods:
- Systematic review of studies on MSS for pain during ROP screening.
- Analysis of tactile (non-nutritive sucking), auditory (white noise), and gustatory (sucrose) interventions.
- Meta-analysis of clinical efficacy data for single-modal versus combined MSS approaches.
Main Results:
- Multisensory stimulation (MSS) encompasses tactile, auditory, and gustatory stimuli, with non-nutritive sucking (NNS), white noise, and sucrose being common examples.
- Analgesic mechanisms involve sensory pathway competition and endogenous opioid release.
- Combined interventions, particularly white noise with NNS, demonstrated superior pain reduction compared to single interventions.
Conclusions:
- Multisensory stimulation (MSS) is a safe and effective non-pharmacological method for managing procedural pain in retinopathy of prematurity (ROP) screening.
- Combined MSS strategies, such as auditory and tactile stimuli, offer the most significant pain relief.
- Evidence-based implementation of MSS can improve the screening experience for premature infants.
Abstract:
Retinopathy of prematurity (ROP) is a retinal disease characterized by abnormal vascular proliferation, primarily associated with premature delivery and low birth weight. Advances in perinatal and neonatal care have increased survival rates but have also contributed to a rising incidence of ROP, necessitating regular ROP screening. However, the screening procedure, which involves an eyelid speculum and ophthalmoscope, frequently induces pain. Given the potential adverse effects of pharmacological interventions, non-pharmacological pain management is essential. Multisensory stimulation (MSS), integrating auditory, olfactory, gustatory, and tactile stimuli, is recommended by guidelines due to its favorable safety profile and proven analgesic efficacy. This review synthesizes evidence regarding MSS for pain management during ROP screening, focusing on three aspects: operational definitions of MSS [tactile stimuli like non-nutritive sucking (NNS), auditory interventions such as white noise, and gustatory agents including 24% sucrose]. Analgesic mechanisms, particularly sensory pathway competition and endorphin release; and clinical efficacy, with meta-analyses demonstrating superior outcomes of combined interventions (white noise combined with NNS) compared to single-modal approaches. This review aims to provide evidence-based guidance for effectively implementing MSS strategies, ultimately minimizing procedural pain.
