Cochrane · systematic review · CD015179
Non‐opioid analgesics for procedural pain in neonates
Persad, E, Pizarro, AB, Bruschettini, M · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
4
No studies
6
Included studies
NR
No studies 6 · 60%Ungraded 0 · 0%Very low 4 · 40%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
NMDA receptor antagonists compared to no treatment, placebo, oral sweet solution, or non‐pharmacological intervention for procedural pain in neonates
Population: Procedural pain in neonates
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during the procedure, NMDA receptor antagonists vs no treatment, placebo, oral sweet solution, or non‐pharmacological intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Pain score assessed up to 10 minutes after the procedure NMDA receptor antagonists vs no treatment, placebo, oral sweet solution, or non‐pharmacological intervention | no estimate extracted | NR | No studies |
Episodes of bradycardia, defined as a fall in heart rate of more than 30% below the baseline or less than 100 beats per minute for 10 seconds or longer, occurring during the procedure NMDA receptor antagonists vs no treatment, placebo, oral sweet solution, or non‐pharmacological intervention | no estimate extracted | NR | No studies |
Episodes of apnea (mean rates of apnea), occurring during the procedure NMDA receptor antagonists vs no treatment, placebo, oral sweet solution, or non‐pharmacological intervention | no estimate extracted | NR | No studies |
Hypotension requiring medical therapy (vasopressors or fluid boluses), occurring during the procedure NMDA receptor antagonists vs no treatment, placebo, oral sweet solution, or non‐pharmacological intervention | no estimate extracted | NR | No studies |
Head‐to‐head comparison of different analgesics for procedural pain in neonates
Population: Procedural pain in neonates
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Pain score assessed up to 10 minutes after the procedure | no estimate extracted | NR | No studies |
Episodes of bradycardia, defined as a fall in heart rate of more than 30% below the baseline or less than 100 beats per minute for 10 seconds or longer, occurring during the procedure | no estimate extracted | NR | No studies |
Episodes of apnea (mean rates of apnea), occurring during the procedure. No. of participants: 124(1 RCT) | RR 0.31 [0.08, 1.18] | NR | Very low Downgraded: risk of bias, imprecision |
Hypotension requiring medical therapy (vasopressors or fluid boluses), occurring during the procedure No. of participants: 124(1 RCT) | RR 5.53 [0.27, 112.3] | NR | Very low Downgraded: risk of bias, imprecision |