Effectiveness and safety of pharmacological interventions for hospitalized neonatal pain ：an overview of systematic review and meta-analysis / 中国药房

ABSTRACT

OB JECTIVE To conduct overview of the systematic revi ew（SR）/meta-analysis for the effectiveness and safety of pharmacological interventions for hospitalized neconatal pain ， and to provide evidence-based reference for neonatal pain management. METHODS CNKI，CBM，Wanfang，VIP，PubMed，Embase，the Cochrane Library ，Web of Science ，CINAHL and Google Scholar were searched for SR/meta-analysis of pharmacological interventions for hospitalized neonatal pain. The search period was from Nov. 1st，2016-Nov. 1st，2021. After literature screening and data extraction ，AMSTAR 2 scale was used to evaluate the methodological quality of the included literature ，and GRADE method was used to assess the evidence quality of the outcome of the include d literature . A su mmary analysis was then conducted. RESULTS Totally 36 outcome indexes of 7 SR/ meta-analysis were included. Five studies were of moderate quality，and two were very poor according to AMSTAR 2 scale. GRADE results showed that among 36 outcome indexes，there were 7 moderate-quality indexes （19.44％），low-quality indexes （61.11％），and 7 critically-low-quality indexes （19.44％）. The main reason for downgrading the quality of evidence was impr ecision of results （71.74％）. CONCLUSIONS Opioids c an significantly reduce t he pain score of mechanically ventilated neonates but may increase hypotension. Acetaminophen can significantly reduce pain scores during eye examinations and postoperative morphine consumption with no adverse reaction report. However ，its analgesic effect on procedural pain is less than glucose and sucrose. Lidocaine and prilocaine and tetracaine may relieve venipuncture and lumbar puncture pain but lidocaine and prilocaine may increase the risk of adverse reaction. Clonidine can reduce neonatal mechanical ventilation pain with no adverse reaction report. It is suggested that neonatal pediatricians should use analgesic drugs selectively based on clinical judgment and pain assessment results.