To synthesize evidence on neonatal pain assessment tools and non-pharmacological analgesic strategies, focusing on clinical implementation and emerging objective or digital assessment approaches.
Approach:
Literature Search: A search was conducted on PubMed, CINAHL, MEDLINE, the Cochrane Library, Web of Science, Scopus, and Embase for peer-reviewed articles published from January 2000 to May 2025, focusing on studies involving preterm or term neonates.
Study Inclusion Criteria: Included studies were primary research, high-quality secondary evidence, and methodological or technological studies addressing neonatal pain assessment tools or non-pharmacological analgesic interventions.
Key Findings:
Validated multidimensional assessment tools are effective for structured evaluation of neonatal pain.
Family-integrated, sensory, and behavioral non-pharmacological approaches can reduce procedural pain responses.
The strength and consistency of evidence are greater for single procedures than for repeated or prolonged pain.
Artificial intelligence-based approaches for pain detection show potential but remain insufficiently validated for routine use.
Interpretation:
Standardized neonatal pain management should integrate validated assessment scales, non-pharmacological care protocols, staff training, and parental involvement.
Limitations:
The review is limited to studies published in English.
The strength of evidence for non-pharmacological interventions is greater for single procedures compared to repeated or prolonged pain.
Conclusion:
Future research should focus on repeated and prolonged pain, high-risk neonatal populations, and the validation of digital assessment systems in clinical settings.
