联合非药物干预方法减轻新生儿操作性疼痛的研究

目的探讨联合使用几种非药物干预方法在临床上减轻新生儿操作性疼痛的效果。方法将63例新生儿随机分成四组,在新生儿接受操作性疼痛刺激时,干预Ⅰ、Ⅱ、Ⅲ组分别采用体位干预＋抚触、口服24％蔗糖水＋非营养性吸吮、口服24％蔗糖水＋非营养性吸吮＋体位干预＋抚触。对照组在穿刺的全过程不给予任何缓解疼痛的干预措施。采用新生儿疼痛量袁（N1PS）比较四组疼痛程度。结果与对照组比较,干预Ⅰ组NIPS评分差异无统计学意义（P〉0．05）,但干预Ⅱ组、干预Ⅲ组差异有统计学意义（均P〈0．01）;与刺激后1min比较,刺激后5min及刺激后10min各组的NIPS评分均迅速下降。结论联合干预方法Ⅱ、Ⅲ均有协同镇痛作用,干预方法Ⅲ减轻新生儿操作性疼痛效果最好。     

联合非药物干预方法减轻新生儿操作性疼痛的研究

目的探讨联合使用几种非药物干预方法在临床上减轻新生儿操作性疼痛的效果。方法将63例新生儿随机分成四组,在新生儿接受操作性疼痛刺激时,干预Ⅰ、Ⅱ、Ⅲ组分别采用体位干预+抚触、口服24%蔗糖水+非营养性吸吮、口服24%蔗糖水+非营养性吸吮+体位干预+抚触。对照组在穿刺的全过程不给予任何缓解疼痛的干预措施。采用新生儿疼痛量表(NIPS)比较四组疼痛程度。结果与对照组比较,干预Ⅰ组NIPS评分差异无统计学意义(P0.05),但干预Ⅱ组、干预Ⅲ组差异有统计学意义(均P0.01);与刺激后1min比较,刺激后5min及刺激后10min各组的NIPS评分均迅速下降。结论联合干预方法Ⅱ、Ⅲ均有协同镇痛作用,干预方法Ⅲ减轻新生儿操作性疼痛效果最好。     

介绍一种肌内注射减轻疼痛的方法

肌内注射刺激性药物时所致的疼痛,常使病人难以忍受,甚至感到恐惧。经临床实践发现,注射中旋转针尖斜面的方向注药,有效减轻其疼痛程度,现介绍如下。     

窒息后喂养不耐受新生儿微量喂养联合非营养性吸吮研究

目的探讨早期微量喂养、非营养性吸吮等护理措施对窒息后新生儿喂养不耐受的治疗效果。方法将67例喂养不耐受的窒息新生儿随机分为观察组(32例)和对照组(35例)。观察组给予早期微量喂养联合非营养性吸吮,并注意喂养时体位、腹部抚触、病情观察与记录等护理措施;对照组给予常规喂养及护理。结果两组患儿均未发生坏死性小肠结肠炎、吸入性肺炎等严重喂养并发症。两组达全量肠内营养时间、恢复至出生体质量时间、血清总胆红素水平、前白蛋白水平等比较,差异有统计学意义(均P0.01)。结论微量喂养联合非营养性吸吮可促进窒息后新生儿胃肠道功能成熟,改善营养状况。     

口服蔗糖减轻肌内注射疼痛效果观察

肌内注射是将少量药液注入肌肉组织的方法[1].肌肉组织血管丰富、神经分布较少,故吸收较快,疼痛较轻.但刺激性大的药液必须行肌内注射时,无疑对患者心理及身体是一种痛苦的刺激,有的甚至因为疼痛而不愿接受治疗.无痛注射法现已成为护理人员操作的目标之一.笔者采用口服蔗糖减轻肌内注射疼痛,效果满意,现报告如下.     

改变注射部位减轻绒促性素肌内注射疼痛

目的探讨减轻肌内注射绒促性素疼痛的方法和效果。方法将76例肌内注射绒促性素治疗的先兆流产患者按照自身对照的方法,将注射单日作为观察组、注射双日作为对照组。两组均于注射前采用复方利多卡因乳膏外敷,在此基础上对照组采用常规注射部位,即髂前上棘与尾骨连线的外上1／3处;观察组采用髂前上棘与尾骨连线的外上1／4处肌内注射．连续注射6d后比较两组的疼痛程度。结果两组疼痛程度比较,差异有统计学意义（P〈0．01）。结论改变注射部住能有效减轻绒促性素肌内注射疼痛,减轻患者痛苦,提高患者治疗依从性。     

改变注射部位减轻绒促性素肌内注射疼痛

目的 探讨减轻肌内注射缄促性素疼痛的方法和效果.方法 将76例肌内注射绒促性素治疗的先兆流产患者按照自身对照的方法,将注射单日作为观察组、注射双日作为对照组.两组均于注射前采用复方利多卡因乳膏外敷,在此基础上对照组采用常规注射部位,即髂前上棘与尾骨连线的外上1/3处;观察组采用髂前上棘与尾骨连线的外上1/4处肌内注射,连续注射6 d后比较两组的疼痛程度.结果 两组疼痛程度比较,差异有统计学意义(P＜0.01).结论 改变注射部位能有效减轻绒促性素肌内注射疼痛,减轻患者痛苦,提高患者治疗依从性.     

注射器内少量空气对肌内注射疼痛的影响

为探讨注射器内少量空气对肌肉注射疼痛的影响。选择１００例门诊患者进行自身对照，采用改良注射液（注射时注射器内有０.2-0.3ml空气）和传统注射法（注射器内无空气）进行常规肌内注射，拔针３０s后评估局部空气能减轻局部疼痛，且减少药物浪费。     

非营养性吸吮与口服葡萄糖对早产儿足跟采血疼痛的影响

目的选择合适的干预方法减轻早产儿足跟釆血疼痛刺激。方法选择30例早产儿,每天1次进行医疗所需足跟釆血,连续4 d,分别在足跟采血前2 min采取安慰奶嘴、口服25%葡萄糖水、安慰奶嘴+25%葡萄糖水、口服灭菌注射用水进行干预,比较足跟采血前后不同时间早产儿疼痛得分、唾液儿茶酚胺和皮质醇浓度。结果非营养性吸吮法、25%葡萄糖水法及两者结合法采血时早产儿疼痛评分显著低于灭菌注射用水法(均P0.05);4种方案下,足跟采血前后不同时间早产儿唾液皮质醇和儿茶酚胺浓度比较,差异无统计学意义(均P0.05)。结论非营养性吸吮、口服25%葡萄糖水或两者结合干预方式均能降低早产儿足跟采血时疼痛得分,但对唾液皮质醇和儿茶酚胺的分泌无显著影响。     

新生儿肌内注射方法的改进

新生儿皮下脂肪较薄,凝血功能尚不健全,采用常规方法肌内注射后容易出现皮下淤血、硬结,有些皮下硬结甚至3～6个月后才能消退.鉴此,我科对新生儿肌内注射方法进行改进,效果显著,介绍如下.     

母乳嗅觉刺激联合非营养性吸吮对早产儿喂养效果的影响

目的 探讨母乳嗅觉刺激联合非营养性吸吮对早产儿喂养进程及肠内营养并发症的影响,为早产儿营养支持提供参考。 方法 将114例早产儿按照随机数字表法分为对照组和干预组各57例。对照组给予常规管饲喂养护理;干预组在对照组基础上实施母乳嗅觉刺激联合非营养性吸吮,即用0.1 mL母乳（3滴）滴至早产儿舌下,并给予安抚奶嘴进行非营养性吸吮,同时用3 mL母乳将大棉签浸润后放置在距离早产儿鼻腔2～3 cm处进行嗅觉刺激。 结果 干预后,干预组全经口喂养时间、胃管留置时间、肠外营养维持时间及住院时间显著短于对照组（均P＜0.05）。两组开始经口喂养时间、出院体质量、喂养不耐受率及医院感染发生率差异无统计学意义（均P＞0.05）。 结论 母乳嗅觉刺激联合非营养性吸吮有利于缩短管饲喂养早产儿喂养过渡时间、胃管留置时间、肠外营养维持时间及住院时间,促进早产儿生长发育。     

A comparison of intramuscular tenoxicam with intramuscular morphine for pain relief following tonsillectomy in children

A double blind trial was conducted to evaluate the analgesic efficacy of intramuscular tenoxicam for pain relief following tonsillectomy in children. Fifty children, aged 3–10 years, were randomly allocated to receive intramuscular tenoxicam 0.75 mg·kg^?1 or intramuscular morphine sulphate 0.2 mg·kg^?1 after induction of anaesthesia. Although the tenoxicam group required significantly more postoperative morphine (mean 57.8 μg·kg^?1 compared with 26.9 μg·kg^?1, P=0.025), the total morphine dose was significantly reduced after tenoxicam (57.8 μg·kg^?1 compared with 226.9 ug·kg^?1, P<0.0001). There was no difference between the quality of analgesia after discharge from recovery. The incidence of postoperative vomiting was significantly reduced after tenoxicam (20%) compared with morphine (71%).     

Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour

Background. The pharmacokinetics of remifentanil suggests thatit may be suitable for analgesia during labour. Methods. In an open pilot study, 36 women requesting meperidinefor analgesia were recruited early in labour and randomizedto receive either meperidine i.m. or remifentanil given as patient-controlledanalgesia (PCA). Pain severity, sedation and anxiety were assessedwith visual analogue scales and overall effective analgesiawas assessed by the woman and midwife. Results. The pain scores were lower in the remifentanil group:median pain score at 60 min was 72 mm for meperidineand 48 mm for remifentanil (P=0.004) and median maximumpain score during the first 2 h was 82.5 mm for themeperidine group and 66.5 mm for the remifentanil group(P=0.009). Both the midwives’ and the women’s assessmentsof overall effective analgesia were higher in the remifentanilgroup [Likert scale (5 = excellent to 1 = poor):     

赖氨匹林静脉滴注、肌肉注射和安痛定注射在小儿高热中的退热效果探讨

目的：探讨赖氨匹林静脉滴注、肌肉注射和安痛定注射在小儿高热中的退热效果。方法选取2011年9月~2014年3月本院收治的150例高热患儿为研究对象,将其随机分为A组（赖氨匹林静脉滴注组）50例、B组（赖氨匹林肌肉注射组）50例和C组（安痛定肌肉注射组）50例,然后将三组患儿的退热时间构成及治疗前后的血清PCT、hs-CRP水平进行统计及比较。结果 A组及B组的退热时间构成优于C组,A组则优于B组,A组及B组治疗后不同时间的血清PCT及hs-CRP均低于C组,A组则低于B组,差异均有统计学意义（P均＜0.05）。结论赖氨匹林在小儿高热中的应用效果好于安痛定,且静脉滴注的应用方式效果相对更好。     

Adhesiolysis and targeted steroid/local anesthetic injection during epiduroscopy alleviates pain and reduces sensory nerve dysfunction in patients with chronic sciatica

PURPOSE: The aim of this study was to evaluate the effect of adhesiolysis followed by the injection of steroid and local anesthetic during epiduroscopy on sensory nerve function, pain, and functional disability in patients with chronic sciatica. METHODS: Epidural adhesiolysis, using epiduroscopy, followed by the injection of steroid and local anesthetic, was scheduled in 19 patients with chronic sciatica refractory to lumbar epidural block. Sensory nerve function in the legs was tested with a series of 2000-Hz (Abeta-fiber), 250-Hz (Adelta-fiber), and 5-Hz (C-fiber) stimuli, using the current perception threshold (CPT), and CPT values and intensity of pain and Roland Morris Disability Questionnaire (RMDQ) scores were assessed before and 1 and 3 months after the epiduroscopy. RESULTS: At all frequencies, the CPT values in the affected legs of patients before the epiduroscopy were significantly higher than those in the unaffected legs. Epidural adhesiolysis was successfully performed in 16 of the 19 patients. In these patients, the CPT values at 2000 and 250 Hz, and the pain and RMDQ scores 1 and 3 months after the epiduroscopy were significantly lower than those before the epiduroscopy, while the CPT value at 5 Hz did change. CONCLUSION: Epidural adhesiolysis followed by the injection of steroid and local anesthetic during epiduroscopy alleviated pain, and functional disability, and reduced dysfunction of Abeta and Adelta fibers in patients with chronic sciatica.     

Chronic blockade of melanocortin receptors alleviates allodynia in rats with neuropathic pain.

We investigated the involvement of the spinal cord melanocortin (MC) system in neuropathic pain. Because we recently demonstrated that MC receptor ligands acutely alter nociception in an animal model of neuropathic pain, in this study we tested whether chronic administration was also effective. We hypothesized that chronic blockade of the spinal MC system might decrease sensory abnormalities associated with this condition. The effects of the MC receptor antagonist SHU9119 (0.5 microg/d) and agonist MTII (0.1 microg/d) were evaluated in rats with a chronic constriction injury of the sciatic nerve. Drugs were continuously infused into the cisterna magna. Antinociceptive effects were measured with tests involving temperature (10 degrees C or 47.5 degrees C) or mechanical (von Frey) stimulation. The administration of MTII increased mechanical allodynia, whereas SHU9119 produced a profound cold and mechanical antiallodynia, altering responses to control levels. The antiallodynic effects of SHU9119 were very similar to those produced by the alpha(2)-adrenergic agonist tizanidine (50 microg/d). The effects of SHU9119 and MTII are most likely mediated through the MC4 receptor, because this is the only MC-receptor subtype present in the spinal cord. We conclude that the chronic administration of MC4-receptor antagonists might provide a promising tool in the treatment of neuropathic pain. IMPLICATIONS: In this study we demonstrated that continuous intrathecal infusion of the melanocortin-receptor antagonist SHU9119 reduces cold and mechanical allodynia in rats with a chronic constriction injury of the sciatic nerve, a lesion producing neuropathic pain.