141 © Springer International Publishing AG 2017 G. Buonocore, C.V. Bellieni (eds.), Neonatal Pain, DOI 10.1007/978-3-319-53232-5_13 C.V. Bellieni (*) • G. Buonocore Universitary Hospital, Le Scotte, Siena, Italy e-mail: cvbellieni@gmail.com 13 Sensorial Saturation and the 3Ts Rule C.V. Bellieni and G. Buonocore A heel prick cannot be an automatic procedure. Patients should always be protago- nists of their cure even when they are small and nonverbally autonomous, and their parents should never be discouraged from participating in these procedures. Some exceptions are obvious, but the main rule in procedural treatments is “involving the patient” [1–5]. Guidelines for the management of neonatal pain have been suggested [6–9], especially in connection with blood sampling, which is often performed by heel prick. To avoid the drawbacks of general and topical analgesics [10–15], nonphar- macologic methods of analgesia have been proposed. These include nonnutritional sucking [15] and instillation of glucose or other sweet liquids on the tongue [16, 17]; glucose is supposed to provide analgesia by stimulating incretion of β-endorphins [16, 18–20] through a preabsorption mechanism [21]. However, although the meth- ods used have reduced the signs of pain perception, they have not eliminated them [22–27]. All these procedures are indeed far from being completely analgesic and are far from involving the patient and their parents, as far as their state allows it. To this aim, we developed a nonpharmacologic system to produce analgesia in newborns during minor invasive procedures [28, 29]. It consists in giving stimuli (tactile, auditory, olfactory, and visual) during a painful minor procedure. These stimuli compete with the pain transmission to the central nervous system, and for this reason, we call it “sensorial saturation” (aka “sensory saturation” or “multisen- sory stimulation”). We have shown that these stimuli are ineffective without the analgesic effect of oral sugar, but, when added to it, they greatly increase the anal- gesic effect of an oral sweet solution. These three types of stimuli can be resumed in the 3Ts rule: using taste (oral sugar), touch (massage), and talk (speaking to the