This review of literature was conducted to evaluate research on the efficacy of nonpharmacological interventions for use with neonates undergoing minimally invasive skin-breaking procedures. This review primarily focuses on the use of nonnutritive sucking, sweet solutions (such as sucrose, dextrose, etc.), and the synergistic effects of combining these therapies. Research reviewed was limited to peer-reviewed studies written in the English language that evaluated the use of nonnutritive sucking and/or sweet solutions as pain management interventions for neonates (aged 0-1 month) undergoing heel lance or venipuncture. The findings of the studies reviewed support the effiaccy of nonnutritive sucking and the administration of sweet solutions as independent interventions for neonatal pain management, and addditionally indicate that employing these interventions together offers significant synergistic analgesic effects. Further research is required to account for the effects of gestational age and blood-collection method (instrument used) on infant pain. Future studies that focus on the multimodal use of various non-pharmacologic therapies to achieve maximal possible synergistic analgesic effects are indicated. The combined use of nonnutritive sucking and sweet solutions is a simple, inexpensive, effective intervention for managing procedural pain in infants, and nurses should advocate for standardization of this intervention in clinical practice.

Bakgrund: Smärta hos barn i samband med procedurer i sjukvården är ett vanligt problem som sjuksköterskan hanterar. Hos barn är smärta tydligt kopplat till rädsla och otrygghet. Syfte: Att kartlägga icke-farmakologiska metoder för att hantera procedursmärta hos barn. Metod: En litteraturstudie med systematisk ansats som studerar kvantitativa studier. Resultat: Tio vetenskapliga studier på ämnet icke-farmakologiska metoder att hantera procedursmärta hos barn i åldern 2–10 år inkluderades i analysen. Smärthanteringsmetoderna kategoriserades under rubrikerna aktiva distraktionsmetoder, passiva distraktionsmetoder och fysikaliska metoder. De aktiva distraktionsmetoderna att barnet blåser såpbubblor eller spelar spel på surfplatta/smartphone eller virtual reality och användning av de fysikaliska metoderna vibration kombinerat med kyla i den medicintekniska produkten Buzzy, visade god evidens. Vidare forskning på ämnet passiv distraktion med sjukhusclowner och effekten av utformningen på sjuksköterskors arbetskläder är önskvärt. Aktiv distraktion visade lovande resultat och vidare kartläggning rekommenderas. Slutsats: Hantering av procedursmärta bör inkludera barns lek med såpbubblor, spel på surfplatta/smartphone, lek med distraktionskort samt de fysikaliska metoderna vibration och kyla. / Background: Pain in children associated with procedures in healthcare is a common problem that nurses deal with. In children, pain is clearly linked to fear and insecurity. Aim: To map non-pharmacological methods to manage procedural pain in children. Method: A literature study with a systematic approach that studies quantitative studies. Results: Ten scientific studies on the topic of non-pharmacological methods of managing procedural pain in children aged 2–10 years were included in the analysis. The pain management methods were categorized under the headings active distraction methods, passive distraction methods and physical methods. The active distraction methods of the child blowing soap bubbles or playing games on a tablet/smartphone or virtual reality and using the physical methods vibration combined with cold in the medical device Buzzy, showed good evidence. Further research on the topic of passive distraction with hospital clowns and the effect of the design on nurses' work clothes is desirable. Active distraction showed promising results and further survey is recommended. Conclusion: Management of procedural pain should include children's play with soap bubbles, tablet/smartphone games, distraction card play, and the physical methods of vibration and cold.

Syftet med denna litteraturstudie var att beskriva de icke-farmakologiska åtgärder som kan göra att incidensen av postoperativt illamående och kräkningar minskar. Studien baseras på tio vetenskapliga artiklar som har noggrant valts ut och kvalitetsgranskats. Resultaten visar att de icke-farmakologiska åtgärder som sjuksköterskan kan utföra och som visar sig hjälpa mot postoperativt illamående och/eller kräkningar är baserade på den österländska läran om människan. Med stimuleringar av vissa bestämda punkter på kroppen kan incidensen av postoperativt illamående och kräkningar minskas. Det finns flera sätt på vilka de stimuleringarna kan göras, samt olika punkter som kan stimuleras. I den kinesiska akupunkturen är det punkt P6 på handleden och i den koreanska handaku-punkturen är det punkter K-K9 och K-D2 som har visat effekt i prevention och behandling av illamående och kräkningar. De åtgärderna har visat sig fungera själva, men också som komplement till de farmakologiska behandlingarna. De icke-farmakologiska åtgärderna ger inte biverkningar samtidigt som de är mindre kostsamma än de farmakologiska. Fler studier behövs dock för att evidensen kan konstateras, samt andra icke-farmakologsika åtgärder visas. / The aim of this literature overview was to describe nonpharmacologic treatments which can decrease incidence of Postoperative Nausea and Vomiting (PONV). This literature overview is based on ten scientific articles which have been systematically searched and critically appraised. Our findings show that the non-pharmacologic treatments which have decreased PONV and which a nurse can achieve are based on Asian traditional medicine like acupressure and acupuncture. By stimulating specific points on the body the incidence of PONV decreases. There are many ways that the stimulation can be achieved. In the Chinese acu-pressure it is the P6 acupoint on the wrist and the K-K9 and K-D2 points in the Korean Hand Acupuncture, that have shown efficacy in preventing and treating PONV. The treatments appeared to have an effect if lonly applied or as a complement to pharmacologic treatments. The nonpharmacologic treatments have no side effects and they are less expensive than pharmacologic treatments. However further studies are required to determine the scientific evidence of our findings and to bring light on some others nonpharmacologic treatments.