Stevens B, Gibbins S, Franck L S
Faculty of Nursing, University of Toronto, Ontario, Canada.
Pediatr Clin North Am. 2000 Jun;47(3):633-50. doi: 10.1016/s0031-3955(05)70230-3.
Pain is a disruptive influence on infants in the NICU. The most obvious and effective strategy to decrease infant pain in the NICU is to stringently limit the frequency of painful procedures, especially those that are most commonly reported (i.e., heel lances and endotracheal suctioning), and have these performed on infants that are most unstable or critically ill by the most experienced person available. Organizational concerns over the cost of NICU care have forced a re-evaluation of the necessity of certain diagnostic and care procedures and a limiting of procedures to those that can be documented to positively affect clinical outcome. Pharmacologic and nonpharmacologic strategies are essential to the prevention and management of neonatal pain, and these should be considered for complementary use for every infant. Research has shown the safety and effectiveness of some of the strategies in reducing mild pain caused by brief invasive procedures; however, many of the studies had methodologic limitations. Therefore, more research is required to determine the comparative efficacy of the various strategies and to document additive or synergistic effects when combined.
疼痛对新生儿重症监护病房（NICU）中的婴儿具有干扰性影响。减少NICU中婴儿疼痛最明显且有效的策略是严格限制疼痛性操作的频率，尤其是那些最常被报告的操作（即足跟采血和气管内抽吸），并由经验最丰富的人员对最不稳定或病情最危急的婴儿进行这些操作。对NICU护理成本的机构性担忧促使人们重新评估某些诊断和护理操作的必要性，并将操作限制在那些有记录表明能对临床结局产生积极影响的操作上。药物和非药物策略对于预防和管理新生儿疼痛至关重要，应该考虑将这些策略用于每个婴儿以互补使用。研究已经表明某些策略在减轻由短暂侵入性操作引起的轻度疼痛方面的安全性和有效性；然而，许多研究存在方法学上的局限性。因此，需要更多研究来确定各种策略的相对疗效，并记录联合使用时的相加或协同效应。
