Pharmacological interventions for the prevention of pain during endotracheal suctioning in ventilated neonates
Abstract
Background: All newborns admitted to the neonatal intensive care unit (NICU) experience pain during routine care and are at increased risk of long-term adverse effects. Endotracheal suctioning (ETS) is one of the most frequently performed procedures in the NICU, causing moderate-to-severe pain. Approximately 50% of extremely preterm neonates require intubation and repeated ETS.
Objectives: To evaluate the benefits and harms of pharmacological interventions for the prevention of pain during ETS in mechanically ventilated neonates.
Search methods: We searched Cochrane CRS, MEDLINE, Embase, CINAHL and three trial registries, together with reference checking. The latest search date was August 2024.
Selection criteria: We included randomised controlled trials (RCTs), quasi-, cluster- and cross-over RCTs of neonates (term and preterm) who were mechanically ventilated via endotracheal or tracheostomy tube and required ETS. Pharmacological interventions were compared to placebo, no intervention, or standard care, or to non-pharmacological interventions.
Data collection and analysis: Critical outcome measures were validated by composite pain scores. Secondary outcomes included physiological and behavioural pain indicators. We used standard Cochrane methods. For continuous outcomes, we used a fixed-effect model and reported mean differences (MDs) with 95% confidence intervals (CIs). For categorical outcomes, we reported the typical risk ratio (RR) and risk difference (RD) and 95% CIs.…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,242 participants or records.
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