Herrington Carolyn J, Olomu Isoken N, Geller Sandra M
Sparrow Health System, Michigan, Lansing, USA.
Clin Nurs Res. 2004 Feb;13(1):53-68. doi: 10.1177/1054773803259665.
Assessment and management of pain in preterm infants is critical and complicated. The addition of salivary cortisol measurement may improve the specificity of assessment and guide care to alleviate pain. The purpose of this study was fourfold: (a) assess the feasibility of a method of saliva collection in premature infants, (b) assess reliability of a method of measuring salivary cortisol in response to heelstick, (c) identify relationships between salivary cortisol and a measure of pain behavior (using CRIES) following heelstick, and (d) identify peak response times for elevations of salivary cortisol following heelstick in preterm infants. This was a prospective, descriptive pilot study. Serial saliva samples were collected from eight healthy infants 30 to 36 weeks' gestational age in a Newborn Intensive Care Unit. Cortisol levels were determined using enzyme-immune assay. Samples were collected without use of stimulants. Sample means supported peak and trough patterns previously described in the literature. Behavioral measures of pain did not correlate well with peak cortisol levels.
早产儿疼痛的评估与管理至关重要且复杂。唾液皮质醇测量的加入可能会提高评估的特异性，并指导护理以减轻疼痛。本研究的目的有四个：（a）评估早产儿唾液采集方法的可行性，（b）评估足跟采血后测量唾液皮质醇方法的可靠性，（c）确定足跟采血后唾液皮质醇与疼痛行为测量指标（使用CRIES）之间的关系，以及（d）确定早产儿足跟采血后唾液皮质醇升高的峰值反应时间。这是一项前瞻性描述性试点研究。在新生儿重症监护病房，从8名孕龄30至36周的健康婴儿中采集系列唾液样本。使用酶免疫测定法测定皮质醇水平。样本采集未使用兴奋剂。样本均值支持先前文献中描述的峰值和谷值模式。疼痛的行为测量指标与皮质醇峰值水平的相关性不佳。
