The effect of music therapy on pain in preterm infants undergoing invasive procedures

Abstract

Background: Prematurity is the leading cause of death in children worldwide (World Health Organization, 2018). Even when children manage to survive this vulnerable stage, they can still suffer from several adverse effects associated with their time spent in the neonatal intensive care unit (NICU) experiencing uncontrolled pain (Williams & Lascelles, 2020). Music therapy (MT) is a non-pharmacological pain management technique that can potentially help alleviate and manage pain during invasive procedures. Research question: Does music therapy have an effect on pain in preterm infants undergoing invasive procedures? PICO Elements: The population is preterm infants undergoing invasive procedures, the intervention is music therapy, and the comparison is no music therapy. The outcome is pain management. Method: A systematic search was undertaken to locate studies using various electronic databases. The PICO framework was used as a foundation from which synonyms could be developed. These were then merged with search tools and limiters to generate a search strategy. The PRISMA framework was used to select the key studies and five RCTs where chosen. The chosen articles where then critically appraised using the CASP tool for RCTs. Ethical aspects where considered. Inclusion Criteria: The studies eligible for inclusion had to have a population of infants, male or female born before 37 weeks of gestation undergoing invasive procedures. Pain was to be measure by validated acute procedural pain assessment tools and physiological parameters. Furthermore, the eligible studies had to be written in English, published after 2017 and studying not more than four intervention groups. Results: The results of the five RCTs collectively were inconclusive. Whilst three of the studies showed an effect of music therapy (MT) on pain, the other two studies showed no statistically significant results. Implications and Recommendations: The need for further research with stronger methods and younger and sicker populations of infants was identified. Furthermore, the need for pain assessment and monitoring was identified and the importance of implementing pain assessment tools within the NICU. The necessity for educating nurses on pain in preterm infants was emphasised.