Manajemen nyeri non farmakologis dalam pengurangan nyeri pada bayi berat badan lahir rendah (BBLR): A systematic review

Abstract

Background: Pain management for LBW undergoing treatment in hospital is crucial. LBW often receive invasive procedures, so both pharmacological and non-pharmacological pain management is needed. Therefore, non-pharmacological pain management is needed which not only reduces pain but can stimulate the baby's growth and development.

Purpose: To analyze the success of pain management using non-pharmacological methods during intravenous insertion procedures, blood sampling, and to assess the effect on pain reduction by measuring using the Premature Infant Pain Profile (PIPP) score.

Method: Review of research articles obtained from the ProQuest, Science Direct, PubMed, Oxford, and SAGE Journal databases. The inclusion criteria for this study were articles with a randomized control trial (RCT) research design published between 2017-2023. The keywords used in the PICO search process were "Neonate, pain assessment, reduced pain, invasive procedures. The search identified 938 studies that were relevant, and seven studies met the inclusion criteria. Article quality evaluation was carried out through the Joanna Briggs Institute (JBI) to assess the quality of research articles, and thematic analysis was used as a data analysis method.

Results: A review of seven articles shows that various effective non-pharmacological pain management in premature and full-term babies are oral stimulation using sweet solutions, audio stimulation, kangaroo mother care (KMC), crochet octopus, HSTT and baby swaddling. A combination of several interventions Non-pharmacological pain management is more effective than one type of intervention.

Conclusion: A combination of several non-pharmacological pain management interventions can effectively reduce pain in LBW.

Suggestion: Neonatal nurses are expected to be able to utilize the KMC method, use of octopus crochet, baby positioning, and swaddling techniques to reduce pain response, increase comfort, and growth and development in low birth weight (LBW) babies.

Keywords: Decreased Pain; Invasive Action; Neonate; Non Pharmacological; Pain Management.

Pendahuluan: Manajemen nyeri untuk BBLR yang menjalani perawatan di RS menjadi krusial. BBLR seringkali menerima prosedur tindakan invasif, sehingga diperlukan manajemen nyeri baik farmakologi maupun non-farmakologi. Oleh karena itu, diperlukan manajemen nyeri non-farmakologi yang tidak hanya mengurangi nyeri tetapi dapat menstimulasi tumbuh kembang bayi.

Tujuan: Untuk menganalisis keberhasilan manajemen nyeri dengan metode non farmakologi selama prosedur tindakan insersi intravena, blood sampling, dan untuk menilai efek terhadap pengurangan nyeri dengan pengukuran menggunakan skor premature infant pain profile (PIPP).

Metode: Review artikel penelitian yang diperoleh dari database ProQuest, Science Direct, PubMed, Oxford, dan SAGE Journal. Kriteria inklusi pada penelitian ini adalah artikel desain penelitian randomized control trial (RCT) yang diterbitkan antara tahun 2017-2023. Kata kunci yang digunakan dalam proses pencarian PICO yaitu "Neonate, pain assessment, reduced pain, dan invasive prosedur. Pencarian mengidentifikasi 938 studi yang relevan dan tujuh studi memenuhi kriteria inklusi. Evaluasi kualitas artikel dilakukan melalui Joanna Briggs Institute (JBI) untuk menilai kualitas artikel penelitian, dan analisis tematik digunakan sebagai metode analisis data.

Hasil: Review pada tujuh artikel menunjukkan bahwa berbagai manajemen nyeri non-farmakologis yang efektif pada bayi prematur dan cukup bulan adalah stimulasi oral menggunakan larutan manis, stimulasi audio, kangaroo mother care (KMC), crochet octopus, HSTT dan baby swaddling Kombinasi dari beberapa intervensi manajemen nyeri non-farmakologi lebih efektif daripada satu jenis intervensi.

Simpulan: Kombinasi beberapa intervensi manajemen nyeri non farmakologi dapat secara efektif menurunkan nyeri pada BBLR.

Saran: Bagi Perawat neonatal diharapkan dapat memanfaatkan metode KMC, penggunaan crochet octopus, posisi bayi, dan teknik pembedongan untuk mengurangi respon nyeri, meningkatkan kenyamanan, dan tumbuh kembang pada bayi berat badan lahir rendah (BBLR).

Kata Kunci: Manajemen Nyeri; Neonatus; Non Farmakologis; Penurunan Nyeri; Tindakan Invasif.