Akçam M, Ormeci A R
Department of Paediatrics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
Acta Paediatr. 2004 Oct;93(10):1330-3.
Pain and stress have been shown to induce significant physiological and behavioural reactions in newborn infants. Pharmacological agents are not recommended in neonates for pain relief in minor procedures. Since different sweet solutions given orally by syringe have been shown to relieve pain in neonates, we decided to compare the analgesic effects of a small dose of glucose solution given orally by spray and by syringe during heel lancing in term neonates, using a validated behavioural acute pain rating scale.
Sixty hyperbilirubinaemic full-term neonates were studied. We used a randomized, masked, placebo-controlled, crossover trial. Each infant was assessed three times receiving 0.5 ml 30% glucose in spray form, 0.5 ml 30% glucose by syringe or 0.5 ml sterile water by syringe in random order, 2 min before heel lancing.
Pain scores were significantly lower in the 30% glucose given either spray or syringe groups compared with the placebo group. No statistically significant difference in pain scores was found between the 30% glucose spray group and 30% glucose syringe group.
A small dose of 0.5 ml 30% glucose spray has an equal analgesic effect to the same dose given by syringe. The spray form has the advantage of being easy to use and is well accepted by newborn babies.
疼痛和应激已被证明会在新生儿中引发显著的生理和行为反应。在新生儿进行小手术时，不建议使用药物进行止痛。由于经注射器口服不同的甜味溶液已被证明可缓解新生儿的疼痛，我们决定使用经过验证的行为急性疼痛评分量表，比较足月新生儿足跟采血时经喷雾和经注射器口服小剂量葡萄糖溶液的镇痛效果。
对60例高胆红素血症足月新生儿进行研究。我们采用随机、盲法、安慰剂对照、交叉试验。在足跟采血前2分钟，每个婴儿以随机顺序接受三次评估，分别为接受0.5毫升喷雾形式的30%葡萄糖、0.5毫升经注射器注射的30%葡萄糖或0.5毫升经注射器注射的无菌水。
与安慰剂组相比，经喷雾或经注射器给予30%葡萄糖的组疼痛评分显著更低。30%葡萄糖喷雾组和30%葡萄糖注射器组之间的疼痛评分未发现统计学上的显著差异。
0.5毫升30%葡萄糖喷雾的小剂量与相同剂量经注射器给药具有同等的镇痛效果。喷雾形式具有使用方便的优点，并且很容易被新生儿接受。
