The effect of facilitated tucking position during painful procedure in pain management of preterm infants in neonatal intensive care unit: a systematic review and meta-analysis

We performed a systematic review and meta-analysis to investigate the effects of facilitated tucking position during painful procedure in pain management of preterm infants. We searched MEDLINE, PEDro, SciELO and the Cochrane Library (until June 2019) for randomized controlled trials. An alpha value <= 0.05 was considered significant. Heterogeneity among studies was examined with Cochran's Q and I-2 statistic, in which values greater than 40% were considered indicative of high heterogeneity and random-effects model was chosen. Analyses were performed with Review Manager 5.3. Fifteen studies met the eligibility criteria, including 664 preterm infants. The meta-analyses showed a significant reduction in pain of - 1.02 (95% CI - 1.7 to - 0.4, N = 216) during endotraqueal suctioning for participants in the facilitated tucking position group (FTPG) compared with routine care group. The meta-analyses showed a non-significant difference in pain - 0.3 (95% CI - 2.05 to - 1.4, N = 88) during heel stick for participants in the FTPG compared with oral glucose group. The meta-analyses showed a non-significant difference in pain for participants in the FTPG compared with oral opioid group 0.2 (95% CI - 1.4 to 1.8, N = 140). Conclusion: Facilitated tucking position may improve the pain during painful procedures.What is Known:center dot Exposure of premature babies to painful procedures is associated with changes in brain development, regardless of other factors.center dot Facilitated tucking reduces the expression of pain in premature infants.What is New:center dot Facilitated tucking position was efficient in pain management of preterm infants when compared to routine care.center dot Facilitated tucking compared to opioid or oral glucose did not achieve a significant reduction in pain intensity.