This systematic review was performed to objectively investigate the analgesic effect of Oral glucose solution related to non-nutritive sucking in newborns during nociceptive procedures.
Neonatal pain could cause several negatively psychological and physical consequences. To the date, non-pharmacological and pharmacological interventions have been two primary option for reducing pain.
Background and aims: The comparative efficacy of glucose solution (GS) versus non-nutritive sucking (NNS) for pain relief in neonate remains controversial. This systematic review was consequently performed to objectively investigate the analgesic effect of Oral GS related to NNS in newborns during nociceptive procedures. Methods: All potential records were searched in PubMed, Web of Science, EMBASE, and the Cochrane Library to capture the randomized controlled trials comparing GS with NNS in terms of pain scores in neonates through January 2017. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. All statistical analyses were completed by using Review Manager (RevMan) version 5.3.0.Results: Four studies, involving 248 neonates, were incorporated into these statistical analyses. For reducing pain scores, no statistical difference was detected when GS compared to NNS (4 trials; mean difference [MD], 0.75; 95% confidence interval [CI], -0.77 to 2.27; P = 0.33).Conclusion: Both the GS and NNS reduced the pain scores in neonates who undergoing Hepatitis B vaccination and venipuncture, but the NNS is more convenience than GS to some extent. Considered the limited evidences, more randomized controlled trials with high-quality, large-scale and appropriate measures time are warranted to further establish the comparative efficacy of these two options.
This study evaluated the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively.
Premature baby's hypothermia will cause short-term as well as long-term morbidities, including oxygen consumption, sepsis, early retinopathy and intraventricular hemorrhage. Therefore, implementation of early intervention strategies is vitally essential to prevent premature hypothermia.
Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods: Systematic searches on PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials (RCTs) or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA v0.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results: This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit (SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00), incidence of hypothermia (RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01) and hyperthermia (RR, 1.82; 95% CI, 1.31 to 2.54l P = 0.00) compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage III/IV between two groups. trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion: Heated gel mattress is a safe and effective rewarming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.
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