Non-pharmaceutical intervention and pain management situation for neonatal analgesia

Reduce behavioral pain response and composite pain scores.

Decrease duration of cry.

Stabilize changes of HR, SpO₂.

Full term neonates

Preterm neonates

Sucrose: small volumes of 24% (0.1–0.3 ml for preterm neonates and 1–2 ml for term neonates)

Glucose: 1ml of 25% or 50% solutions

Concerns: potential neurological adverse effects for repeated use of sucrose in preterm infants

Grade of recommendation: strong

Lower pain scores (PIPP)

Lower frequency of stress-related behaviors, abnormal rates, oxygen saturation.

Preterm neonates

Full term neonates

At least performing 3 min before painful procedure

Grade of recommendation: strong

Reduce pain scores

Lower increase in heart rate

Reduce cry time

Term infants

Starting 2 min before and continuing the procedure

Grade of recommendation: strong

Reduce pain perceptions

Term infants

Performing during the procedure, such as received vaccination, and safe in mechanically ventilated neonates

Grade of recommendation: strong

PIPP

Shorter time to recovery

Lower facial actions

Reduce cry time

Useful for very preterm neonates preterm neonates

Grade of recommendation: strong

Stabilization for heart rates, oxygen saturation

PIPP

Preterm infants

Grade of recommendation: strong

Reduce pain response

Improve pain recovery

Preterm infants

Usually use before a heel stick

Grade of recommendation: strong

Reduce pain scores (ABC) scale)

Term neonates

Grade of recommendation: strong

Stabilize HR, SaO₂, pain

Improve physiological and behavioral parameters

Preterm neonates

Term neonates

Play familiar music of fetal period, light music or their mother's voice

Grade of recommendation: weak