Kangaroo Care for Relieving Neonatal Pain Caused by Invasive Procedures: A Systematic Review and Meta-Analysis

OBJECTIVE: Neonates develop significant pain responses during invasive procedures, and nonpharmacological interventions are better means of pain relief. An increasing number of studies have confirmed the effectiveness of kangaroo care (KC) in relieving neonatal pain caused by invasive procedures, but conclusions are inconsistent. In this study, a literature search and meta-analysis were performed to evaluate the effect of kangaroo care on relieving neonatal pain. METHODS: The works of literature related to the application of KC in neonatal invasive procedures in the databases of Pubmed, Embase, Springer Link, Ovid, CNKI, and CBM were searched, and the RCT literature from database establishment to July 2022, was selected to evaluate the risk of bias, combined with statistical pain relief outcome indicators. RESULTS: 12 pieces of literature were finally included in this study, with a total of 1172 newborns, including 585 newborns (49.9%) using KC and 587 newborns (50.1%) using the control group method. Meta-analysis showed that an infant's heart rate during invasive procedures under KC intervention was significantly lower than that of other interventions (MD = −6.77, 95% CI (−13.03, −0.50), Z = −2.12, P=0.03), but compared to other nonpharmacological interventions, there was no clear advantage in the overall evaluation of pain reduction in infants (MD = −0.36, 95% CI (−0.80, 0.08), Z = −1.60, P=0.11). CONCLUSION: The heart rate of KC intervention during invasive procedures in infants is significantly lower than that of other interventions, and it can significantly relieve pain in infants, but the effect is not more than that of oral sucrose (or glucose) or standard care. KC combined with oral sucrose may achieve a better pain relief effect in infants, but more studies are still needed to verify it.