口服葡萄糖加非营养性吸吮缓解新生儿疼痛

目的探讨口服葡糖糖加非营养性吸吮缓解新生儿疼痛的效果,为新生儿疼痛管理提供依据。方法将新生儿监护中心胎龄≥30周且喂奶量≥5ml/次、日龄≥2d的新生儿随机分为干预组和对照组,干预组新生儿在静脉穿刺及动脉采血操作前2min喂葡萄糖0.5～2ml,并给予非营养性吸吮;对照组新生儿在创伤性操作过程中不给予任何干预。观察两组新生儿动、静脉穿刺时的疼痛程度、哭闹持续时间、心率、呼吸和血氧饱和度变化。结果口服葡糖糖加非营养性吸吮组新生儿疼痛程度低,哭闹持续时间短,心率、呼吸频率及血氧饱和度变化也小于对照组,差异均有统计学意义(P0.05或0.01)。结论口服葡萄糖加非营养性吸吮可明显减轻新生儿的疼痛反应。     

非营养性吸吮缓解新生儿疼痛的临床研究

目的探讨非营养吸吮(NNS)缓解新生儿疼痛的临床有效性及可行性,为NNS在新生儿病房的推广提供依据。方法患儿分为NNS组40例,对照组40例。选用新生儿急性疼痛行为评分量表(DAN)对接受足跟取血的80例新生儿进行疼痛评分。结果对照组患儿疼痛总分为8.03±1.74分,NNS组患儿疼痛总分为4.68±1.54分,NNS组患儿在面部表情、肢体活动、声音表现各方面得分均有显著下降,各方面得分差异均具有显著意义(P<0.01),NNS组和对照组患儿疼痛得分与其性别、胎龄、日龄及体重等均无显著关系(P>0.05)。结论应重视新生儿疼痛的管理,NNS操作简单,镇痛效果良好,对在临床工作中缓解新生儿疼痛具有良好的实用性。     

非营养性吸吮对静脉穿刺新生儿疼痛的影响

目的探讨非营养性吸吮对静脉穿刺新生儿疼痛的影响,为新生儿疼痛管理提供参考依据。方法将204例静脉穿刺新生儿（其中102例为早产儿,102例为足月儿）随机分为A、B、C、D四组,A、B两组为早产儿．C、D两组为足月儿。A组早产儿给予非营养性吸吮;B组早产儿不给予任何干预;C组足月儿给予非营养性吸吮;D组足月儿不给予任何干预。采用新生儿疼痛评分（NIPS）,观察各组新生儿对疼痛的反应。结果静脉穿刺时A、C两组新生儿疼痛评分明显低于B、D两组,P〈0．01。结论静脉穿刺时进行非营养性吸吮可明显减轻新生儿疼痛反应,值得临床推广应用。     

非营养性吸吮和吸吮8%葡萄糖水对缓解新生儿疼痛的效果观察

目的探索非药物治疗缓解新生儿疼痛的有效方法。方法将130例住院新生儿随机分为非营养性吸吮组和吸吮8%葡萄糖水组,各65例,在采足跟血疼痛刺激前30s、穿刺后20s、1min、3min分别记录心率、呼吸、经皮血氧饱和度和哭声持续时间,并在穿刺1min后根据新生儿面部编码系统、新生儿疼痛评估量表进行疼痛评分。结果穿刺后20s两组新生儿心率加快(P0.01),1min时恢复到穿刺前水平;穿刺后20s、1min两组新生儿呼吸频率均加快(P0.05),3min时恢复到穿刺前水平;两组新生儿穿刺前后经皮血氧饱和度均无明显变化(P0.05);穿刺后吸吮8%葡萄糖水组新生儿哭声持续时间少于非营养性吸吮组(P0.01);吸吮8%葡萄糖水组新生儿面部编码系统和新生儿疼痛评估量表评分均低于非营养性吸吮组(P0.05或P0.01)。结论新生儿对急性疼痛很敏感,吸吮8%葡萄糖水对新生儿有相对较好的止痛作用,在临床护理中,可应用非药物治疗干预措施。     

蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛的干预效果

[目的]观察蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛的干预效果及其安全性。[方法]根据纳入标准便利选取需要经历反复操作性疼痛的早产儿67例并将其随机分为对照组和干预组,对照组经历反复操作性疼痛时接受常规护理,干预组接受蔗糖液联合非营养性吸吮护理,采用早产儿疼痛评分量表(PIPP)评估早产儿疼痛,采用安全性评定指标评估蔗糖液联合非营养性吸吮的安全性。[结果]干预组早产儿PIPP评分低于对照组(P0.05),两组安全性评定指标之间的差异无统计学意义。[结论]蔗糖液联合非营养性吸吮对早产儿反复操作性疼痛干预效果具有持久性、安全性。     

非营养性吸吮联合拥抱抚触对缓解新生儿疼痛的效果观察

目的:探讨非药物治疗措施缓解新生儿疼痛的效果。方法:将80例住院新生儿随机分为非营养性吸吮组(对照组)和非营养性吸吮联合拥抱抚触组(观察组)各40例,在采足跟血疼痛刺激前,刺激后20 s、1 min、3 min分别记录心率、呼吸、经皮氧饱和度和哭声持续时间,并在穿刺1 min后根据新生儿面部编码系统、新生儿疼痛评估量表进行疼痛评分。结果:穿刺后20 s两组新生儿心率加快(P<0.05),1 min时心率恢复到穿刺前水平;穿刺后20 s、1 min两组新生儿呼吸频率均加快(P<0.05),3 min时恢复到穿刺前水平;两组新生儿穿刺前后经皮血氧饱和度均无明显变化(P>0.05),穿刺后非营养性吸吮联合拥抱抚触组新生儿哭声持续时间少于非营养性吸吮组(P<0.05);且新生儿面部编码系统和新生儿疼痛评估量表评分均低于非营养性吸吮组(P<0.05)。结论:新生儿对急性疼痛很敏感,非药物治疗干预措施有较好的止痛作用,综合两种非药物治疗措施缓解新生儿疼痛效果更明显。     

非营养性吸吮与袋鼠式护理对缓解新生儿疼痛的临床对照分析

目的 对非营养性吸吮与袋鼠式护理对缓解新生儿疼痛的临床疗效行对比分析.方法 选取2018年11月—2019年12月某院出生的180例足月儿,随机分为非营养性吸吮组(Non-nutritional Sucking,NNS)、袋鼠式护理组(Kangaroo Mother Care,KMC)和对照组,然后对新生儿用针刺足跟取血,期间对其生理指标进行监测和进行新生儿疼痛评分(Neonatal Infant Pain Scale,NIPS),以评估疼痛缓解程度.结果 NNS组、KMC组与对照组比较,非营养性吸吮与袋鼠式护理均可明显缓解新生儿疼痛,结果有显著差异(P<0.01);但在生理指标和NIPS评分上,NNS组与KMC组组间差异没有统计学意义.结论 非营养性吸吮与袋鼠式护理对缓解新生儿疼痛均有相似的、明显的效果.     

非营养性吸吮联合口服葡萄糖对新生儿置管疼痛的影响

目的:探讨非营养性吸吮联合口服葡萄糖对新生儿置管疼痛的影响。方法:将130例住院需行静脉置管的新生儿随机分为干预组和对照组各65例。干预组于操作前2 min口服1～2 ml葡萄糖液并将安慰奶头放入患儿口中至操作结束后;对照组按常规进行置管操作,不施加任何干预措施。采用新生儿疼痛量评分、疼痛面容持续时间、啼哭时间等指标评估比较两组新生儿疼痛反应的程度。结果:干预组患儿新生儿疼痛评分明显低于对照组(P<0.01),疼痛面容持续时间和啼哭持续时间较对照组明显缩短(P<0.01)。结论:非营养性吸吮联合口服葡萄糖能有效减轻新生儿置管疼痛的程度。     

抚触和非营养性吸吮对新生儿足跟采血时疼痛程度的影响研究

目的:观察抚触和非营养性吸吮对新生儿足跟采血时心率和疼痛程度的影响,探索有效缓解新生儿疼痛的方法。方法:将150例住院新生儿随机分为3组:对照组、应用非营养性吸吮组和抚触组,每组50例,观察足跟采血时各组心率的变化,并应用新生儿疼痛量表进行疼痛程度评分。结果:足跟采血时,各组新生儿的心率均显著加快,与对照组比较,非营养性吸吮和抚触干预措施均可缓解疼痛刺激引起的心率和评分变化,差异有显著性意义(P<0.01)。结论:不同的干预方法对缓解新生儿疼痛的近期效果不同,非营养性吸吮缓解疼痛效果优于抚触组。     

母亲声音联合非营养性吸吮在新生儿疼痛管理中的应用

目的:观察并比较非营养性吸吮(NNS)、母亲声音(MV)、母亲声音联合非营养性吸吮(MV+NNS)在缓解新生儿足跟采血时疼痛的效果。方法:选取2017年12月至2018年10月在青岛大学附属医院新生儿科住院的患儿120例,按随机原则分为空白对照组和干预组(包括NNS组、MV组和MV+NNS组)各30例。对照组行常规护理措施,干预组在常规护理措施基础上给予干预,干预时间从足跟采血前5 min开始至采血结束后10 min。应用新生儿疼痛评估量表(NIPS)对四组新生儿分别进行评分,判断新生儿疼痛程度;观察新生儿心率、血氧饱和度的波动情况。结果:患儿足跟采血期间均出现心率增快、血氧饱和度降低的情况,干预组与空白对照组之间心率、血氧饱和度差异有统计学意义(P<0.05),其中MV+NNS组心率、血氧饱和度变化幅度最小,较其他三组比较,差异有统计学意义(P<0.05);干预组啼哭人数及NIPS评分均少于空白对照组,差异有统计学意义(P<0.05)。MV+NNS组在啼哭人数及NIPS评分上与其他三组比较,差异有统计学意义(P<0.05)。结论:母亲声音联合非营养性吸吮可明显缓解新生儿的疼痛反应,大大降低新生儿的疼痛程度,无不良反应的发生,在新生儿的临床护理工作中具有十分重要的意义。     

Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine

Context

Newborns are subject to pain during routine invasive procedures. Pain caused by immunization injections is preventable, but remains untreated in neonates.

Objectives

The purpose of the study was to compare the effectiveness of three nonpharmacological pain relief strategies on newborns’ pain, physiological parameters, and cry duration before, during, and after hepatitis B intramuscular (IM) injection.

Methods

In this prospective, randomized clinical trial, we enrolled 165 newborns (gestational age, ≥36 weeks). The infants received IM injections and were randomized to three treatment groups: nonnutritive sucking (NNS), 20% oral sucrose, or routine care. Pain was measured by the Neonatal Facial Coding System, physiological signals by electrocardiogram monitors, and cry duration using a stopwatch.

Results

Pain was significantly lower among infants in the NNS (B = −11.27, P < 0.001) and sucrose (B = −11.75, P < 0.001) groups than that in controls after adjusting for time effects, infant sleep/wake state, number of prior painful experiences, and baseline pain scores. Infants in the NNS and sucrose groups also had significantly lower mean heart and respiratory rates than the controls. Cry duration of infants receiving sucrose was significantly shorter than those in the NNS (Z = −3.36, P < 0.001) and control groups (Z = −7.80, P < 0.001).

Conclusion

NNS and oral sucrose can provide analgesic effects and need to be given before painful procedures as brief as a one-minute IM injection. Sucrose orally administered two minutes before injection more effectively reduced newborns’ pain during injection than NNS. Both nonpharmacological methods more effectively relieved newborns’ pain, stabilized physiological parameters, and shortened cry duration during IM hepatitis injection than routine care.     

口腔按摩与非营养性吸吮对早产儿经口喂养的促进作用研究

目的:观察口腔按摩联合非营养性吸吮在早产儿经口喂养中的促进作用。方法:将62例早产儿随机分为试验组和对照组各31例。两组均给予预防感染、肠外营养、小剂量金双歧、鼻饲等基础支持治疗,试验组外加口腔按摩及非营养性吸吮。比较两组的临床疗效。结果:治疗后两组早产儿在喂养不耐受、平均留置胃管时间、经口喂养起始时间、3周后体重情况等方面比较,具有统计学意义,P0.05。结论:在基础支持治疗上,对早产儿及时实施口腔按摩联合非营养性吸吮等辅助方法,在提高早产儿经口喂养的吸吮能力中有明显促进作用,能加快其口腔功能发育的成熟,使其早期建立正常的吸吮能力。     

安抚奶嘴联合抚触缓解新生儿静脉穿刺疼痛的效果观察

目的探讨安抚奶嘴联合抚触对新生儿静脉穿刺疼痛的影响。方法选择在本科室住院的92例静脉穿刺新生儿,按随机原则分为两组,抚触组(A组)、安抚奶嘴联合抚触组(B组),在新生儿静脉穿刺前、中、后分别比较新生儿疼痛评分、心率和血氧饱和度情况。结果 B组新生儿静脉穿刺中、后疼痛评分明显低于A组,两组比较,差异具有统计学意义(均P0.001),B组新生儿静脉穿刺中、后心率明显慢于对照组,血氧饱和度明显高于对照组,两组比较,差异具有统计学意义(均P0.001)。结论安抚奶嘴联合抚触能有效缓解新生儿静脉穿刺疼痛,维持生命体征趋于平稳,值得临床推广应用。     

非营养性吮吸对新生儿疼痛干预效果的研究

目的 探讨减轻新生儿疼痛的非药物疗法.方法 将住院的100例新生儿随机分为未干预组和应用非营养性吮吸(NNS)组,在进行静脉采血过程中,采用新生儿疼痛评估量表(NIPS)对两组新生儿进行评分,同时监测采血前后心率、呼吸、SpO2改变.结果 NNS组在采血时,对疼痛的反应明显轻于未干预组,其差异具有统计学意义(P＜0.0...     

新生儿重症监护病房新生儿疼痛的评估及干预

目的研究新生儿重症监护病房对新生儿疼痛的评估,分析相关的干预措施的影响。方法将患儿分为对照组(不作处理)、NNS组(非营养性吸吮)、NNS+GS组(非营养性吸吮加葡萄糖)。3组患儿在桡动脉处进行穿刺,并在穿刺前、中、后期使用多参数心电监护仪对患儿的心率、呼吸频率、经皮氧饱和度进行监测。使用疼痛评分简表(PIPP)对各组新生儿患者的疼痛进行评估。结果对照组的一次穿刺成功率低于NNS组及NNS+GS组,NNS组的一次穿刺成功率低于NNS+GS组(P0.05);对照组PIPP评分高于NNS组、NNS+GS组,NNS+GS组PIPP评分低于NNS组(P0.05);患儿桡动脉穿刺时的心率、呼吸均加快,Sp O2降低(P0.05),其中NNS组及NNS+GS组干预后心率、呼吸、Sp O2的变化比对照组小(P0.05),且可较快恢复至穿刺前。结论心率、呼吸频率、经皮氧饱和度可作为评估新生儿疼痛的生理性指标,PIPP评分能够简便评估疼痛。非营养性吸吮、非营养性吸吮结合葡萄糖均能缓解新生儿疼痛,但非营养性吸吮结合葡萄糖止痛效果更好,临床上可推广使用。     

A Review of CAM for Procedural Pain in Infancy: Part I. Sucrose and Non-nutritive Sucking

There is increasing concern regarding the number of painful medical procedures that infants must undergo and the potential risks of alleviating infant pain with conventional pharmacologic agents. This article is Part I of a two-part series that aims to provide an overview of the literature on complementary and alternative (CAM) approaches for pain and distress related to medical procedures among infants up to six weeks of age. The focus of this article is a review of the empirical literature on sucrose with or without non-nutritive sucking (NNS) for procedural pain in infancy. Computerized databases were searched for relevant studies including prior reviews and primary trials. The most robust evidence was found for the analgesic effects of sucrose with or without NNS on minor procedural pain in healthy full-term infants. Despite some methodological weaknesses, the literature to date supports the use of sucrose, NNS and other sweetened solutions for the management of procedural pain in infancy.     

Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial

BackgroundSucrose combined with non-nutritive sucking provided better pain relief than sucrose or non-nutritive sucking alone in a single painful procedure. However, whether the combination of non-nutritive sucking with sucrose could obtain a significant difference in analgesic effect of the repeated procedural pain than any single intervention has not been established.ObjectiveTo compare the effect of non-nutritive sucking and sucrose alone and in combination of repeated procedural pain in preterm infants.DesignRandomized controlled trial.SettingA level III neonatal intensive care unit of a university hospital in China.MethodPreterm infants born before 37 weeks of gestation were randomly assigned to four groups: routine care group (routine comfort through gentle touch when infants cried; n = 21), non-nutritive sucking group (n = 22), sucrose group (0.2 ml/kg of 20%; n = 21), sucrose (0.2 ml/kg of 20%) plus non-nutritive sucking group (n = 22). Each preterm infant received three nonconsecutive routine heel sticks. Each heel stick included three phases: baseline (the last 1 min of the 30 min without stimuli), blood collection, recovery (1 min after blood collection). Three phases of 3 heel stick procedures were videotaped. Premature infant pain profile (PIPP) score, heart rate, oxygen saturation and percentage of crying time were assessed by five independent evaluators who were blinded to the purpose of the study at different phases across three heel sticks. Data were analyzed by analysis of variance, with repeated measures at different evaluation phases of heel stick.Results86 preterm infants completed the protocol. During the blood collection and recovery phases, combination group, had lower PIPP score (4.4 ± 1.5; 3.0 ± 0.8), lower heart rate (138.6 ± 7.9; 137.4 ± 4.7), higher oxygen saturation (95.2 ± 1.6; 96.0 ± 1.2), and smaller percentage of crying time (11.5 ± 8.6; 4.6 ± 3.4), compared with the group has given non-nutritive sucking (9.3 ± 1.3, 6.8 ± 1.4; 154.2 ± 9.0, 148.0 ± 9.3; 92.9 ± 2.4, 94.1 ± 1.0; 44.2 ± 9.6, 31.2 ± 10.5; respectively) or sucrose (10.1 ± 2.0, 7.4 ± 1.6; 151.6 ± 9.6, 147.9 ± 6.9; 93.5 ± 1.7, 94.5 ± 1.2; 53.8 ± 16.7, 35.2 ± 13.9; respectively) or routine care (13.3 ± 1.6, 10.6 ± 1.9; 156.8 ± 7.2, 151.7 ± 7.9; 92.9 ± 2.1, 93.8 ± 1.6; 80.6 ± 7.6, 68.2 ± 9.9; respectively). Both non-nutritive sucking and sucrose were more effective in reducing preterm infants’ PIPP score and percentage of crying time than routine care. There was no difference in PIPP score, heart rate, oxygen saturation and percentage of crying time between the non-nutritive sucking and sucrose groups.ConclusionThe combination of non-nutritive sucking with sucrose provided better pain relief during repeated painful procedures than when non-nutritive sucking or sucrose was used alone. The effect of non-nutritive sucking was similar to that of sucrose on repeated procedural pain.     

口腔感觉运动刺激疗法协同非营养性吸吮对极低出生体质量早产儿吸吮吞咽功能障碍的影响

目的:探讨口腔感觉运动刺激疗法协同非营养性吸吮对极低出生体质量早产儿吸吮吞咽功能障碍的影响。方法:将90例极低出生体质量早产儿随机分成A组、B组、C组各30例。A组采用非营养性吸吮,B组采用口腔感觉运动刺激疗法,C组采用口腔感觉运动刺激疗法协同非营养性吸吮。观察并记录两组早产儿开始经口喂养时间、达到完全经口喂养时间、留置胃管时间、静脉营养时间、住院天数。结果:C组早产儿开始经口喂养时间、达到完全经口喂养时间、留置胃管时间、静脉营养时间及平均住院天数均短于A组(P<0.05),B组以上方面与A组比较有统计学意义(P<0.05),B组以上方面与C组比较无统计学意义(P>0.05)。结论:口腔感觉运动刺激疗法协同非营养性吸吮可以改善极低出生体质量早产儿吸吮吞咽功能障碍,使之尽快达到经口喂养,早期出院。     

肌肤接触安抚联合非营养性吸吮在新生儿操作性疼痛干预中的应用

目的:探讨肌肤接触安抚联合非营养性吸吮在新生儿操作性疼痛干预中的应用效果。方法:选取本院2018年2月—2019年2月入住新生儿监护病房的98例新生儿作为研究对象,随机分为A组32例、B组33例、C组33例,在对新生儿进行致痛性操作时,A组同时给予肌肤接触安抚和非营养性吸吮干预措施,B组只给予肌肤接触安抚措施,C组只给予非营养性吸吮干预措施。比较3组新生儿的疼痛量表(NIPS)评分和生命体征变化情况。结果:A组NIPS评分最低,且A组与B组或C组间比较差异都有统计学意义(P<0.05);A组与B组或C组的心率、呼吸状况、平均动脉压、血氧饱和度比较差异均有统计学意义(P<0.05),而B组、C组间差异并无统计学意义(P>0.05)。结论:肌肤接触安抚联合非营养性吸吮能缓解新生儿的操作性疼痛,并能维持生命体征的稳定,联合干预比单一干预措施效果更佳。