Management of Pain From Heel Stick in Neonates: An Analysis of Research Conducted in Thailand

The heel stick procedure is the most common painful procedure performed in preterm and full-term neonates. Various nonpharmacologic interventions have been used for pain relief. However, the magnitude of the effect of different interventions has received little attention. In this study, 4 eligible studies conducted in Thailand, focusing on the effects of interventions on pain responses to heel stick procedure in neonates, were obtained for analysis. Swaddling in full-term newborns was found to have the largest mean effect size (d^mn = 0.79). However, the moderate-to-large effect sizes (d^mn = 0.5-0.75) of positioning in preterm newborns tended to exist throughout the poststick period while the effect sizes of other interventions decreased over time. The effect sizes of these interventions for physiological responses varied.