Neonates admitted to the Neonatal Intensive Care Unit (NICU) are routinely exposed to painful procedures essential for diagnosis and treatment, including heel pricks, venipunctures, and intubations. Due to their immature physiological systems and inability to verbally express pain, effective pain management in this population remains both critical and complex. This study systematically reviews existing evidence to compare the effectiveness of pharmacological and non-pharmacological interventions in managing procedural pain among neonates in NICU settings. Pharmacological approaches, such as the use of analgesics and sedatives, are commonly employed for moderate to severe pain but may carry potential risks and side effects. In contrast, non-pharmacological methods—including kangaroo care, oral sucrose, breastfeeding, and swaddling—offer safer, low-cost alternatives, particularly for mild to moderate pain. The findings indicate that while pharmacological interventions are effective for severe pain, non-pharmacological strategies significantly reduce pain responses and are beneficial as complementary or standalone interventions in less invasive procedures. A combined, multimodal approach is recommended to optimize neonatal pain management and improve clinical outcomes
Carter et al. (Mon,) studied this question.
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