Guidelines for procedural pain in the newborn

被引:157
作者
Lago, Paola [1 ]
Garetti, Elisabetta [2 ]
Merazzi, Daniele [3 ]
Pieragostini, Luisa [4 ]
Ancora, Gina [5 ]
Pirelli, Anna [6 ]
Bellieni, Carlo Valerio [7 ]
机构
[1] Univ Padua, Dept Paediat, Neonatal Intens Care Unit, I-35128 Padua, Italy
[2] Azienda Osped Univ Policlin Modena, Neonatal Intens Care Unit, Modena, Italy
[3] St Anna Hosp, Neonatal Intens Care Unit, Como, Italy
[4] San Filippo Neri Hosp, Neonatal Intens Care Unit, Rome, Italy
[5] Univ Bologna, S Orsola M Malpighi Hosp, Neonatal Intens Care Unit, Bologna, Italy
[6] Osped San Gerardo, Neonatal Intens Care Unit, Monza, Italy
[7] Univ Siena, Dept Paediat Obstet & Reprod Med, I-53100 Siena, Italy
关键词
Analgesia; Guidelines; Newborn infant; Pain management; Sedation; NEONATAL ENDOTRACHEAL INTUBATION; RANDOMIZED CONTROLLED-TRIAL; LUMBAR PUNCTURE; HEEL-PRICK; SUCROSE ANALGESIA; LOCAL-ANESTHESIA; CARE; PREMEDICATION; RETINOPATHY; FACILITATION;
D O I
10.1111/j.1651-2227.2009.01291.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Despite accumulating evidence that procedural pain experienced by newborn infants may have acute and even long-term detrimental effects on their subsequent behaviour and neurological outcome, pain control and prevention remain controversial issues. Our aim was to develop guidelines based on evidence and clinical practice for preventing and controlling neonatal procedural pain in the light of the evidence-based recommendations contained in the SIGN classification. A panel of expert neonatologists used systematic review, data synthesis and open discussion to reach a consensus on the level of evidence supported by the literature or customs in clinical practice and to describe a global analgesic management, considering pharmacological, non-pharmacological, behavioural and environmental measures for each invasive procedure. There is strong evidence to support some analgesic measures, e.g. sucrose or breast milk for minor invasive procedures, and combinations of drugs for tracheal intubation. Many other pain control measures used during chest tube placement and removal, screening and treatment for ROP, or for postoperative pain, are still based not on evidence, but on good practice or expert opinions. Conclusion: These guidelines should help improving the health care professional's awareness of the need to adequately manage procedural pain in neonates, based on the strongest evidence currently available.
引用
收藏
页码:932 / 939
页数:8
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