Massage for pain relief in newborns submitted to puncture: systematic review

Costa, Thatiane Monick de Souza; Oliveira, Eloysa dos Santos; Silva, Bruna Vilar Soares da; Melo, Evelin Beatriz Bezerra de; Carvalho, Fernanda Oliveira de; Duarte, Fernando Hiago da Silva; Dantas, Rodrigo Assis Neves; Dantas, Daniele Vieira

doi:10.1590/1983-1447.2022.20220029.en

Thatiane Monick de Souza Costa

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0002-8827-9653

Eloysa dos Santos Oliveira

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Departamento de Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0001-9635-3668

Bruna Vilar Soares da Silva

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Departamento de Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0002-4199-238X

Evelin Beatriz Bezerra de Melo

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Departamento de Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0003-1822-8022

Fernanda Oliveira de Carvalho

Universidade Federal de Sergipe (UFS), Departamento de Fisioterapia. São Cristóvão, Sergipe, Brasil.

http://orcid.org/0000-0002-1270-406X

Fernando Hiago da Silva Duarte

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0002-2743-0452

Rodrigo Assis Neves Dantas

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0002-9309-2092

Daniele Vieira Dantas

Universidade Federal do Rio Grande do Norte (UFRN), Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Natal, Rio Grande do Norte, Brasil.

http://orcid.org/0000-0003-0307-2424

Corresponding author
Daniele Vieira Dantas E-mail: daniele00@hotmail.com

Associate editor

Carlise Rigon Dalla Nora

Editor-in-chief

Maria da Graça Oliveira Crossetti

Authorship contribution

Project administration: Daniele Vieira Dantas. Formal analysis: Thatiane Monick de Souza Costa, Fernanda Oliveira de Carvalho, Fernando Hiago da Silva Duarte, Daniele Vieira Dantas. Conceptualization: Thatiane Monick de Souza Costa, Fernanda Oliveira de Carvalho, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas. Data curation: Thatiane Monick de Souza Costa, Eloysa dos Santos Oliveira, Bruna Vilar Soares da Silva, Evelin Beatriz Bezerra de Melo. Writing-original draft: Thatiane Monick de Souza Costa, Eloysa dos Santos Oliveira, Bruna Vilar Soares da Silva, Evelin Beatriz Bezerra de Melo, Fernanda Oliveira de Carvalho, Fernando Hiago da Silva Duarte, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas. Writing-review & editing: Thatiane Monick de Souza Costa, Eloysa dos Santos Oliveira, Bruna Vilar Soares da Silva, Evelin Beatriz Bezerra de Melo, Fernanda Oliveira de Carvalho, Fernando Hiago da Silva Duarte, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas. Investigation: Thatiane Monick de Souza Costa, Eloysa dos Santos Oliveira, Bruna Vilar Soares da Silva, Evelin Beatriz Bezerra de Melo, Fernanda Oliveira de Carvalho, Daniele Vieira Dantas. Methodology: Thatiane Monick de Souza Costa, Fernanda Oliveira de Carvalho, Fernando Hiago da Silva Duarte, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas. Visualization: Thatiane Monick de Souza Costa, Eloysa dos Santos Oliveira, Bruna Vilar Soares da Silva, Evelin Beatriz Bezerra de Melo, Fernanda Oliveira de Carvalho, Fernando Hiago da Silva Duarte, Rodrigo Assis Neves Dantas, Daniele Vieira Dantas.

The authors declare that there is no conflict of interest.

Data Source	Search Strategy
MEDLINE-PubMed	(((infant) OR (newborn) OR (premature) OR (baby)) AND ((Massage) OR (Reflexotherapy)) AND ((pain) OR (“Pain Measurement”) OR (“Pain Management”) OR (“Pain relief”) OR (“Pain assessment”) OR (Puncture)))
Web of Science	(Infant, newborn OR premature OR baby) AND TÓPICO: (massage OR reflexotherapy) AND TÓPICO: (pain OR pain measurement OR pain management OR pain relief OR pain assessment OR puncture)
CINAHL	(Infant, newborn OR premature OR baby) AND (massage OR reflexotherapy) AND (pain OR pain measurement OR pain management OR pain relief OR pain assessment OR puncture)
SCOPUS	(ALL (infant AND newborn OR premature OR baby) AND ALL (massage OR reflexotherapy) AND ALL (pain OR pain AND measurement OR pain AND management OR pain AND relief OR pain AND assessment OR puncture))
Cochrane Library	(All Text (infant, newborn OR premature OR baby) AND All Text (massage OR reflexotherapy) AND All Text (pain OR pain AND measurement OR pain AND management OR pain AND relief OR pain AND assessment OR puncture))
Gale Academic OneFile	(infant, newborn) AND (massage OR reflexotherapy) AND (pain OR pain AND measurement OR pain AND management OR pain AND relief OR pain AND assessment OR puncture)

Author/ Country/Year	Study type/ Level of evidence	Population	Groups	Massage site	Massage time	Results
Abasi et al.2424. Abasi Z, Salari E, Rasahidi F, Taherpour M. Effect of massage on the intensity of pain caused by vaccination in newborn infants. J North Khorasan Univ Med Sci. 2011;3(3):51-6. doi: https://doi.org/10.29252/jnkums.3.3.51 https://doi.org/10.29252/jnkums.3.3.51 ... / Iran/2011	Randomized clinical trial/1B	60 full-term newborns	IG*) Effleurage and petressage massage (30) CG†) No intervention (30)	Effleurage massage on the body and petressage on the extremities.	30 minutes	After 30 minutes of intervention, the mean pain intensity in the experimental group was lower than in the control group.
Abbasoğlu et al.2525. Abbasoglu A, Cabıoğlu MT, Tuğcu AU, Ince DA, Tekindal MA, Ecevit A, et al. Acupressure at BL60 and K3 points before heel lancing in preterm infants. Explore. 2015;11(5):363-6. doi: https://doi.org/10.1016/j.explore.2015.07.005 https://doi.org/10.1016/j.explore.2015.0... / Turkey/ 2015	Randomized clinical trial/1B	32 newborns (GA‡ 28-36 weeks)	IG) Acupressure (16) CG) Usual care (16)	Acupressure applied to BL60 and K3.	3 minutes	The mean duration of the procedure and crying were lower in the acupressure group.
Abdallah et al.2626. Abdallah B, Badr LK, Hawwari M. The efficacy of massage on short and long term outcomes in preterm infants. Infant Behav Dev. 2013;36(4):662-9. doi: https://doi.org/10.1016/j.infbeh.2013.06.009. https://doi.org/10.1016/j.infbeh.2013.06... / Lebanon/2013	Quasi-experimental study/3A	50 newborns (GA 26-36 weeks)	IG) Moderate pressure massage (27) CG) No intervention (23)	Head, neck, back of neck, shoulders, arms, legs, buttocks, and hips	10 minutes	Reduction in PIPP^§ after massage, and at discharge, compared to the control group. And increased cognitive scores.
Chik et al.2727. Chik YM, Ip WY, Choi KC. The effect of upper limb massage on infants’ venipuncture pain. Pain Manag Nurs. 2017;18(1):50-7. doi: https://doi.org/10.1016/j.pmn.2016.10.001 https://doi.org/10.1016/j.pmn.2016.10.00... / China/2017	Randomized clinical trial/1B	80 newborns (GA 30 to 40 weeks)	IG) Light pressure massage (40) CG) Usual care (40)	Upper limbs	2 minutes	The mean difference between pain scores between receiving massage and control treatment was lower.
Jain et al.2828. Jain S, Kumar P, Mcmillan DD. Prior leg massage decreases pain responses to heel stick in preterm babies. J Paediatr Child Health. 2006;42(9):505-8 doi: https://doi.org/10.1111/j.1440-1754.2006.00912.x https://doi.org/10.1111/j.1440-1754.2006... / Canada/ 2006	Randomized clinical trial/1B	23 newborns (GA 28-35 weeks)	IG) Light pressure massage (13) CG) No intervention (10)	In the punctured limb, toes and thigh.	2 minutes	HR^\|\|, mean serum cortisol and NIPS^¶ were higher in the control group.
Mathai et al.2929. Mathai S, Natrajan N, Rajalakshmi NR. A comparative study of non-pharmacological methods to reduce pain in neonates. Indian Pediatr. 2006 [cited 2020 Dez 15];43(12):1070-5. Available from: https://www.indianpediatrics.net/dec2006/1070.pdf . https://www.indianpediatrics.net/dec2006... / India/2006	Randomized clinical trial/1B	104 full-term newborns (> 24 hours of life)	IG) Extracted Breast Milk; sucrose; NNS**; Massage; and Swinging. CG) Absent	Massage the forehead, chest, arms and legs in a cyclic manner.	2 minutes	At 2 and 4 minutes pain scores were lower in the NNS and swing groups. The total duration of crying was also shorter in the NNS and swing groups.
Mirzarahimi et al.3030. Mirzarahimi M, Mehrnoush N, Shahizadeh S, Samadi N, Amani F. Effect of non-nutritive sucking and leg massage on physiological and behavioral indicators of pain following heel blood sampling in term neonates. Int J Nurs Stud. 2013;2(2):74-9. doi: https://doi.org/10.14419/ijans.v2i2.578 https://doi.org/10.14419/ijans.v2i2.578... / Iran/2013	Randomized clinical trial/1B	90 newborns (IGl up to 37 weeks)	IG) Massage (30) and NNS (30) CG) No intervention (30)	Punctured limb, toes to thigh.	2 minutes	Lower variation in SpO2^†† in the massage group. Changes in PIPP scores were lower in the massage group.
Özkan et al.3131. Özkan TK, Küçükkelepçe DS, Özkan SA. The effects of acupressure and foot massage on pain during heel lancing in neonates: a randomized controlled trial. Complement Ther Med. 2019;46:103-8. doi: https://doi.org/10.1016/j.ctim.2019.08.004 https://doi.org/10.1016/j.ctim.2019.08.0... / Turkey/ 2019	Randomized clinical trial/1B	139 full-term NB^‡‡ (GA 38 to 40 weeks)	IG) Acupressure (46) and massage (47) CG) No intervention (46)	Acupressure at Kun Lun (UB60) and Taixi (K3) points and foot.	2 minutes	The acupressure, massage and control groups had means of 4.30 ± 2.25, 3.95 ± 2.63, 6.04 ± 1.26, respectively.
Rafati et al.3232. Rafati S, Rejeh N, Tadrisi S, Karimi M, Molodi A. Effect of massage on physiological pain responses of blood sampling in infants. Iran J Nurs Res. 2015 [cited 2020 Dez 15];10(2):45-53. Available from: http://ijnr.ir/article-1-1525-en.html http://ijnr.ir/article-1-1525-en.html... / Iran/2015	Randomized clinical trial/1B	136 newborns admitted to the NICU***	IG) Efleurage massage (68) CG) Usual care (68)	Antecubital fossa	1 minute	Pain intensity mean in the experimental group was lower than in the control group and reduced crying time during procedure.
Roshanray et al.3333. Roshanray A, Rayyani M, Dehghan M, Faghih A. Comparative effect of mother’s hug and massage on neonatal pain behaviors caused by blood sampling: a randomized clinical trial. J Trop Pediatr. 2020;66(5):479-86. doi: https://doi.org/10.1093/tropej/fmaa001 https://doi.org/10.1093/tropej/fmaa001... / Iran/2020	Randomized clinical trial/1B	135 newborns (GA 38-42 weeks)	IG) Massage (45) and maternal hug (45) CG) Usual care (45)	Foot massage, from fingertips to mid-leg	2 minutes	After 5 minutes, pain and HR decreased in the maternal hug group compared to the massage and control groups. The duration of crying in the maternal hug group was shorter than in the other groups.
Salimi et al.3434. Salimi T, Dehghani K, Afkhami A, Karjoo Z, Shadkam MN, Zadeh HF. Comparing the effect of breast-milk and leg massage on neonate’s pain intensity during heel-blood sampling in Neonatal Care Unit. JSSU. 2020;27(12):2192-202. doi: https://doi.org/10.18502/ssu.v27i12.2835 https://doi.org/10.18502/ssu.v27i12.2835... / Iran/2020	Randomized clinical trial/1B	30 newborns from the Neonatal Care Unit	IG) Breastfeeding and Massage (15) CG) Massage and Breastfeeding (15)	Massage performed on the lower limbs	3 minutes	There was a significant difference for the pain score during and after the intervention of each of the two groups.
Zargham-boroujeni et al.3535. Zargham-Boroujeni A, Elsagh A, Mohammadizadeh M. The effects of massage and breastfeeding on response to venipuncture pain among hospitalized neonates. Iran J Nurs Midwifery Res. 2017;22(4):308-12. doi: https://doi.org/10.4103/ijnmr.IJNMR_119_13 https://doi.org/10.4103/ijnmr.IJNMR_119_... / Iran/2017	Randomized clinical trial/1B	75 newborns (GA > 34 weeks)	IG) Massage (25) and Breastfeeding (25) CG) No intervention (25)	Effleurage massage at the venous puncture site.	3 minutes	The lowest mean pain score was recorded in the massage group. The ANOVA test and post hoc statistics revealed that both interventions resulted in a significant reduction in pain scores.

[1] Corresponding author
Daniele Vieira Dantas E-mail: daniele00@hotmail.com

Brasil

Brasil

Massage for pain relief in newborns submitted to puncture: systematic review

Masaje para el alivio del dolor en recién nacidos sometidos a punción: revisión sistemática

ABSTRACT

Objective

Method

Results

Conclusion