Archives of Disease in Childhood 2008;93:ps423
Copyright © 2008 by BMJ Publishing Group Ltd.



A VanBrakel1, B Bogers1, O Helder1

1 Division of Neonatology, Department of Pediatrics, Erasmus Mc-Sophia Children’s Hospital, Rotterdam, The Netherlands

Background: Most infants cared for in a Neonatal Intensive Care Unit receive mechanical respiratory support. Consequently they undergo painful and stressful interventions e.g endotracheal suctioning (ETS) and heel punctures. Pain relief by analgesia is frequently discussed in the literature. Non-pharmacological pain management like sucrose in combination with non-nutritive sucking is well studied. Recently, studies concerning facilitated tucking (FT) to comfort infants who undergo short mild or moderate painful procedures are published. In the current practice nurses provide FT to infants who undergo ETS. What is, however, the state of the art with respect to pain and stress reduction during ETS?

Objective: This review describes the effectiveness of facilitated tucking in infants during endotracheal suctioning.

Method: Systematic search was performed in electronic databases including PubMed, Cochrane library and CINHAL to identify literature published from January 1988 to January 2008. Used keywords were facilitated tucking, pain management, and suction. Included were articles concerning neonates from 24 to 32 weeks gestation.

Results: Ten articles out of 621 generated hits were selected, two crossover studies concerning ETS, three crossover studies concerning heel lance, one study during routine care, one systematic review concerning non-pharmacological pain management and three general articles concerning non-pharmacological pain management including FT.

Conclusion: There was little high-level evidence for FT. All studies conclude that FT may be an effective non-pharmacological intervention during short painful procedures. FT had a favourable effect on pulse rate, respiration and on reduction of motor activity. Additionally, FT provided by parents may be effective in pain management.

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.