Effects of white noise on procedural pain-related cortical response and pain score in neonates: A randomized controlled trial.
Xuyan Ren, Li Li, Siya Lin and 2 others
PMID 35891905WHAT IT FOUND
White noise did not reduce pain scores or brain oxygen response during arterial punctures in 60 NICU neonates.
The faster recovery trend was not convincing.
Key findings
01Maximum PIPP-R pain scores during arterial puncture were similar in the white noise and sham groups, with a median difference of -0.5 on a 0-18 scale and P=0.376.
02Pain-related cortical oxygen response during puncture did not differ between groups: minimum rScO2 mean difference -0.325, P=0.540; mean rScO2 mean difference -0.138, P=0.804.
03Secondary outcomes also showed no significant group differences: mean HR difference 0.33, P=0.946; SpO2 median difference -1, P=0.051; duration of painful expressions median difference -9, P=0.635.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 60 neonates were analyzed, and the authors state the study was not powered enough to detect subtle effects. Six of 66 randomized neonates were excluded for hearing screening failure or technical problems. Neonates were selected by convenience sampling, not random sampling from the NICU population. The intervention lasted only 2 min before and 5 min after the puncture, and the authors say this may have been too short to show effects. The study included only term neonates and excluded neonates with congenital anomalies, severe illness, sedatives, muscle relaxants, antiepileptic drugs, oxygen therapy, or fever, so it may not apply to those groups. The faster recovery trends in the white noise group were not statistically significant and cannot be treated as evidence of benefit.
Declared interests
The authors declared no conflict of interest. The work was supported by grants from the Guangdong Nurse Association and the Department of Science and Technology of Guangdong Province.
The easy way to misread this
Do not read the faster recovery trend as evidence that white noise reduces neonatal procedural pain. The trial found no significant difference in pain score, cortical response, heart rate, oxygen saturation, or duration of painful expressions.