skip to main content
review-article

Kangaroo Care for Relieving Neonatal Pain Caused by Invasive Procedures: : A Systematic Review and Meta-Analysis

Published: 01 January 2022 Publication History

Abstract

Objective. Neonates develop significant pain responses during invasive procedures, and nonpharmacological interventions are better means of pain relief. An increasing number of studies have confirmed the effectiveness of kangaroo care (KC) in relieving neonatal pain caused by invasive procedures, but conclusions are inconsistent. In this study, a literature search and meta-analysis were performed to evaluate the effect of kangaroo care on relieving neonatal pain. Methods. The works of literature related to the application of KC in neonatal invasive procedures in the databases of Pubmed, Embase, Springer Link, Ovid, CNKI, and CBM were searched, and the RCT literature from database establishment to July 2022, was selected to evaluate the risk of bias, combined with statistical pain relief outcome indicators. Results. 12 pieces of literature were finally included in this study, with a total of 1172 newborns, including 585 newborns (49.9%) using KC and 587 newborns (50.1%) using the control group method. Meta-analysis showed that an infant’s heart rate during invasive procedures under KC intervention was significantly lower than that of other interventions (MD = −6.77, 95% CI (−13.03, −0.50), Z = −2.12, P=0.03), but compared to other nonpharmacological interventions, there was no clear advantage in the overall evaluation of pain reduction in infants (MD = −0.36, 95% CI (−0.80, 0.08), Z = −1.60, P=0.11). Conclusion. The heart rate of KC intervention during invasive procedures in infants is significantly lower than that of other interventions, and it can significantly relieve pain in infants, but the effect is not more than that of oral sucrose (or glucose) or standard care. KC combined with oral sucrose may achieve a better pain relief effect in infants, but more studies are still needed to verify it.

References

[1]
D. Koller and R. D. Goldman, “Distraction techniques for children undergoing procedures: a critical review of pediatric research,” Journal of Pediatric Nursing, vol. 27, no. 6, pp. 652–681, 2012.
[2]
G. Pancekauskaitė and L. Jankauskaitė, “Paediatric pain medicine: pain differences, recognition and coping acute procedural pain in paediatric emergency room,” Medicina (Kaunas), vol. 54, no. 6, p. 94, 2018.
[3]
D. Harrison, J. Reszel, M. Bueno, M. Sampson, V. S. Shah, A. Taddio, C. Larocque, and L. Turner, “Breastfeeding for procedural pain in infants beyond the neonatal period,” Cochrane Database of Systematic Reviews, vol. 10, no. 10, 2016.
[4]
B. Stevens, C. Johnston, P. Petryshen, and A. Taddio, “Premature infant pain profile: development and initial validation,” The Clinical Journal of Pain, vol. 12, no. 1, pp. 13–22, 1996.
[5]
M. Filippa, M. G. Monaci, C. Spagnuolo, P. Serravalle, R. Daniele, and D. Grandjean, “Maternal speech decreases pain scores and increases oxytocin levels in preterm infants during painful procedures,” Scientific Reports, vol. 11, no. 1, 2021.
[6]
C. McNair, M. Campbell-Yeo, C. Johnston, and A. Taddio, “Nonpharmacologic management of pain during common needle puncture procedures in infants: current research evidence and practical considerations: an update,” Clinics in Perinatology, vol. 46, no. 4, pp. 709–730, 2019.
[7]
H. Zengin and N. Cinar, “Designing dress (Sarbebe) for kangaroo care, the effect of kangaroo care provided with this dress on mother and newborn's comfort,” Health Care for Women International, vol. 43, no. 6, pp. 642–662, 2022.
[8]
M. Campbell-Yeo, C. C. Johnston, B. Benoit, T. Disher, K. Caddell, M. Vincer, C. D. Walker, M. Latimer, D. L. Streiner, and D. Inglis, “Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial,” Pain, vol. 160, no. 11, pp. 2580–2588, 2019.
[9]
N. B. de Sousa Freire, J. B. S. Garcia, and Z. C. Lamy, “Evaluation of analgesic effect of skin-to-skin contact compared to oral glucose in preterm neonates,” Pain, vol. 139, no. 1, pp. 28–33, 2008.
[10]
B. Stevens, J. Yamada, and A. Ohlsson, “Sucrose for analgesia in newborn infants undergoing painful procedures,” Cochrane Database of Systematic Reviews, vol. 3, 2004.
[11]
S. Minozzi, K. Dwan, F. Borrelli, and G. Filippini, “Reliability of the revised Cochrane risk-of-bias tool for randomised trials (RoB2) improved with the use of implementation instruction,” Journal of Clinical Epidemiology, vol. 141, pp. 99–105, 2022.
[12]
B. J. Stevens, S. Gibbins, J. Yamada, K. Dionne, G. Lee, C. Johnston, and A. Taddio, “The premature infant pain profile-revised (PIPP-R): initial validation and feasibility,” The Clinical Journal of Pain, vol. 30, no. 3, pp. 238–243, 2014.
[13]
A. J. Mitchell, C. C. Yates, D. K. Williams, J. Chang, and R. W. Hall, “Does daily kangaroo care provide sustained pain and stress relief in preterm infants?” Journal of Neonatal-Perinatal Medicine, vol. 6, no. 1, pp. 45–52, 2013.
[14]
E. Sen and G. Manav, “Effect of kangaroo care and oral sucrose on pain in premature infants: a randomized controlled trial,” Pain Management Nursing, vol. 21, no. 6, pp. 556–564, 2020.
[15]
H. Gao, G. Xu, H. Gao, R. Dong, H. Fu, D. Wang, H. Zhang, and H. Zhang, “Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: a randomized controlled trial,” International Journal of Nursing Studies, vol. 52, no. 7, pp. 1157–1165, 2015.
[16]
X. Cong, R. M. Cusson, S. Walsh, N. Hussain, S. M. Ludington-Hoe, and D. Zhang, “Effects of skin-to-skin contact on autonomic pain responses in preterm infants,” The Journal of Pain, vol. 13, no. 7, pp. 636–645, 2012.
[17]
S. Nimbalkar, V. V. Shukla, V. Chauhan, A. Phatak, D. Patel, A. Chapla, and A. Nimbalkar, “Blinded randomized crossover trial: skin-to-skin care vs. sucrose for preterm neonatal pain,” Journal of Perinatology, vol. 40, no. 6, pp. 896–901, 2020.
[18]
V. Shukla, A. Chapla, J. Uperiya, A. Nimbalkar, A. Phatak, and S. Nimbalkar, “Sucrose vs. skin to skin care for preterm neonatal pain control-a randomized control trial,” Journal of Perinatology, vol. 38, no. 10, pp. 1365–1369, 2018.
[19]
L. Kristoffersen, R. Støen, H. Bergseng, T. Follestad, E. Theodorsson, B. Vederhus, L. Adde, and D. Austeng, “Skin-to-skin contact during eye examination did not reduce pain compared to standard care with parental support in preterm infants,” Acta Paediatrica, vol. 108, no. 8, pp. 1434–1440, 2019.
[20]
A. G. Chermont, L. F. M. Falcão, E. H. L. de Souza Silva, R. de Cássia Xavier Balda, and R. Guinsburg, “Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants,” Pediatrics, vol. 124, no. 6, pp. e1101–e1107, 2009.
[21]
R. Kostandy, G. C. Anderson, and M. Good, “Skin-to-skin contact diminishes pain from hepatitis B vaccine injection in healthy full-term neonates,” Neonatal Network, vol. 32, no. 4, pp. 274–280, 2013.
[22]
L. Gray, L. Watt, and E. M. Blass, “Skin-to-skin contact is analgesic in healthy newborns,” Pediatrics, vol. 105, no. 1, p. e14, 2000.
[23]
X. Cong, S. M. Ludington-Hoe, G. McCain, and P. Fu, “Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study,” Early Human Development, vol. 85, no. 9, pp. 561–567, 2009.
[24]
S. M. Ludington-Hoe, R. Hosseini, and D. L. Torowicz, “Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick,” AACN Clinical Issues: Advanced Practice in Acute and Critical Care, vol. 16, no. 3, pp. 373–387, 2005.
[25]
T. C. Castral, F. Warnock, A. M. Leite, V. J. Haas, and C. G. Scochi, “The effects of skin-to-skin contact during acute pain in preterm newborns,” European Journal of Pain, vol. 12, no. 4, pp. 464–471, 2008.
[26]
F. Okan, A. Ozdil, A. Bulbul, Z. Yapici, and A. Nuhoglu, “Analgesic effects of skin-to-skin contact and breastfeeding in procedural pain in healthy term neonates,” Annals of Tropical Paediatrics, vol. 30, no. 2, pp. 119–128, 2010.
[27]
J. J. Liaw, L. Yang, K. W. Katherine Wang, C. M. Chen, Y. C. Chang, and T. Yin, “Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomised controlled crossover trial,” International Journal of Nursing Studies, vol. 49, no. 3, pp. 300–309, 2012.
[28]
R. R. Pillai Riddell, N. M. Racine, H. G. Gennis, K. Turcotte, L. S. Uman, R. E. Horton, S. Ahola Kohut, J. Hillgrove Stuart, B. Stevens, and D. M. Lisi, “Non-pharmacological management of infant and young child procedural pain,” Cochrane Database of Systematic Reviews, vol. 2015, no. 12, 2015.
[29]
V. V. Shukla, A. J. Chaudhari, S. M. Nimbalkar, A. G. Phatak, D. V. Patel, and A. S. Nimbalkar, “Skin-to-Skin care by mother vs. Father for preterm neonatal pain: a randomized control trial (environ trial),” International Journal of Pediatrics, vol. 2021, pp. 1–6, 2021.
[30]
D. V. Patel, S. N. Soni, V. V. Shukla, A. G. Phatak, M. K. Shinde, A. S. Nimbalkar, and S. M. Nimbalkar, “Efficacy of skin-to-skin care versus swaddling for pain control associated with vitamin K administration in full-term neonates: a randomized controlled trial,” Journal of Tropical Pediatrics, vol. 68, no. 4, 2022.
[31]
Z. Kashaninia, F. Sajedi, M. Rahgozar, and F. A. Noghabi, “The effect of Kangaroo Care on behavioral responses to pain of an intramuscular injection in neonates,” Journal for Specialists in Pediatric Nursing, vol. 13, no. 4, pp. 275–280, 2008.
[32]
X. Cheng, F. Huang, K. Zhang, X. Yuan, and C. Song, “Effects of none-steroidal anti-inflammatory and antibiotic drugs on the oral immune system and oral microbial composition in rats,” Biochemical and Biophysical Research Communications, vol. 507, no. 1-4, pp. 420–425, 2018.
[33]
X. Cheng, F. He, M. Si et al., “Effects of antibiotic use on saliva antibody content and oral microbiota in Sprague Dawley rats[J],” Frontiers in Cellular and Infection Microbiology, p. 42, 2022.

Index Terms

  1. Kangaroo Care for Relieving Neonatal Pain Caused by Invasive Procedures: A Systematic Review and Meta-Analysis
          Index terms have been assigned to the content through auto-classification.

          Recommendations

          Comments

          Information & Contributors

          Information

          Published In

          cover image Computational Intelligence and Neuroscience
          Computational Intelligence and Neuroscience  Volume 2022, Issue
          2022
          32389 pages
          ISSN:1687-5265
          EISSN:1687-5273
          Issue’s Table of Contents
          This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

          Publisher

          Hindawi Limited

          London, United Kingdom

          Publication History

          Published: 01 January 2022

          Qualifiers

          • Review-article

          Contributors

          Other Metrics

          Bibliometrics & Citations

          Bibliometrics

          Article Metrics

          • 0
            Total Citations
          • 0
            Total Downloads
          • Downloads (Last 12 months)0
          • Downloads (Last 6 weeks)0
          Reflects downloads up to 04 Jan 2025

          Other Metrics

          Citations

          View Options

          View options

          Media

          Figures

          Other

          Tables

          Share

          Share

          Share this Publication link

          Share on social media