Reducing procedural pain in preterm infants by facilitated tucking

Abstract

Background: Premature infants admitted to the intensive care unit are exposed to various painful procedures as part of their daily routine. Growing evidence shows that early exposure to pain is associated with both short- and long-term consequences (CDC,2021). Thus, the implementation of non-pharmacological pain management in the NICU is crucial to protect the development of the infants. Facilitated tucking position is a therapeutic intervention that can potentially reduce procedural pain (Axelin et al., 2006). Hence, the purpose of this review is to discover the effectiveness of FT in relieving pain during painful procedures. Research Question: Does facilitated tucking help to relieve pain during painful procedures in preterm infants? PICO Elements: The population (P) included were preterm infants. The intervention (I) studied was performing FT during painful procedures and compared (C) with standard care. Finally, the desired outcome (O) was reduced pain levels. Method: Following the PICO question, a detailed literature search was conducted by utilizing five reliable databases. The inclusion and exclusion criteria were formulated to identify studies that were most applicable to the research question. The inclusion criteria included; peer-reviewed articles, English language, studies published after 2009, Systematic Reviews (SR), Meta Analysis, Randomised Controlled Studies (RCT), cohort studies, experimental and cross-sectional studies ,and premature infants. The systematic search resulted in retrieving five studies which included one systematic review and four randomised controlled trials. The appropriate Critical Appraisal Skills Programme (CASP) tool was applied to serve as a guideline to critically appraise the chosen studies. Ethical issues were also taken into consideration. Results and Conclusion: From the studies obtained, four out of five studies showed a statistically significant difference in reducing the pain score when facilitated tucking was performed. Nonetheless, due to limitations encountered in these studies, cautious interpretation of results was crucial and further research is recommended. Implications and Recommendations: Further investigation on Facilitated Tucking is needed to establish credible evidence on the effectiveness of this intervention. Moreover, education to healthcare professionals and students regarding the incorporation of non-pharmacological interventions during procedural pain including FT is essential. The implementation of local clinical guidelines following evidence-based information regarding this matter was also recommended.