Cochrane · systematic review · CD015594
Pharmacological interventions for the management of pain and discomfort during lumbar puncture in newborn infants
Pessano, S, Romantsik, O, Olsson, E, et al. · 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
7
current version
GRADE rated
6
No studies
1
Included studies
NR
No studies 1 · 14.3%Ungraded 0 · 0%Very low 5 · 71.4%Low 1 · 14.3%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
Topical anesthetics compared to placebo or no intervention for the management of pain and discomfort during lumbar puncture in newborn infants
Population: newborn infants undergoing lumbar puncture
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Successful LP on first attempt № of LPs: 100(1 quasi‐RCT) Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Total number of LP attempts № of LPs: 100(1 quasi‐RCT) Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Episodes of bradycardia, defined as a fall in heart rate to > 30% below the baseline or < 100 beats per minute for ≥ 10 seconds № of LPs: 100(1 quasi‐RCT) Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
NFCS pain score during the procedure№ of infants: 112(2 RCTs) Score Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | Low Downgraded: risk of bias, inconsistency |
Episodes of desaturation, defined as a decrease in arterial SpO2 to < 80% (no minimum duration specified) № of LPs: 100(1 quasi‐RCT) Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Apnea: number of episodesduring the procedure Topical anesthetics vs placebo or no intervention | no estimate extracted | NR | No studies |
Apnea: occurrence of one or more episodes№ of LPs: 100(1 quasi‐RCT) Topical anesthetics vs placebo or no intervention | RR 3.24 [0.14, 77.79] | NR | Very low Downgraded: risk of bias, imprecision |