Pain management in nursing procedures on premature babies

BACKGROUND: Pain can be caused to premature babies when nursing and other procedures are carried out. Procedural pain management for these babies raises challenging questions for health care professionals. Optimal pain management for premature babies can be reached by using and further developing existing pharmacological and non-pharmacological pain alleviation methods for procedural pain before, during, and after procedures. AIMS: The aims of this study were to describe the environment of pain management in nursing procedures and examinations with premature babies; to describe preparation of the baby for the procedure; to describe non-pharmacological pain alleviation methods during and after the procedures; and to develop a process describing procedural pain management in premature babies. METHOD: The material for this study consisted of journal articles on non-pharmacological procedural pain alleviation in infants published between 1994 and 2002. During this period knowledge of pain management in premature babies has improved considerably. The study was based on the method of content analysis. FINDINGS: Procedural pain management in premature babies was described by researchers as a process comprising: (1) an environment that is favourable to effective pain management, (2) safe preparation of the baby for the procedure, (3) pain alleviation during the procedure, and (4) restoring the baby's sense of security after the procedure. Pain management is recommended to be used alone or together with pharmacological interventions. Additionally, systematic pain management requires documentation of the whole pain management process. CONCLUSION: Pain management can be described as a process. It is important to test and assess this process and individual non-pharmacological pain management methods in practical nursing situations. The findings of this review can be used to improve pain management methods in premature babies.