Allegaert Karel, Devlieger Hugo, Bulckaert Dominiek, Naulaers Gunnar, Casaer Paul, Tibboel Dick
Department of Pediatrics, University Hospital Gasthuisberg Leuven, Belgium.
J Perinat Med. 2005;33(5):442-8. doi: 10.1515/JPM.2005.078.
To document pain expression characteristics in former preterm infants in the first year of life in whom systematic evaluation and treatment of pain was provided.
Data on the Modified Behavioral Pain Scale (MBPS), Visual Analogue Scale (VAS, crying time and heart rate were collected during immunization. The effect of clinical characteristics {postconception and gestational age [PCA], surgery, ventilation, fentanyl, length of stay (LOS)} on bio-behavioral parameters was evaluated.
121 procedures were recorded in 49 infants. GA was 28 (25-32) weeks. PCA was 60 (34-90) weeks. Median MBPS was 8 (2-10), median crying time 44 (0-112) s. Median pre-procedural heart rate was 144 (103-201) and increased to 184 (147-220) afterwards, resulting in a relative increase of 29 (5-99)%. Median VAS score was 7 (1-10). Significant correlations of PCA with pre-procedural heart rate (r=-0.36) and with relative increase in heart rate (r=0.33) were identified. A correlation of LOS on crying time (r=0.37) was observed.
Correlations of PCA with pre-procedural and relative increase in heart rate reflect the maturational decrease in heart rate. LOS had an effect on pain expression, potentially reflecting the impact of cumulative 'minor' procedural pain.
记录在生命第一年接受疼痛系统评估和治疗的 former preterm infants 的疼痛表达特征。
在免疫接种期间收集改良行为疼痛量表（MBPS）、视觉模拟量表（VAS）、哭闹时间和心率的数据。评估临床特征（孕龄和胎龄[PCA]、手术、通气、芬太尼、住院时间[LOS]）对生物行为参数的影响。
49 名婴儿记录了 121 次操作。孕龄为 28（25 - 32）周。PCA 为 60（34 - 90）周。MBPS 中位数为 8（2 - 10），哭闹时间中位数为 44（0 - 112）秒。操作前心率中位数为 144（103 - 201），之后升至 184（147 - 220），相对增加 29（5 - 99）%。VAS 评分中位数为 7（1 - 10）。确定 PCA 与操作前心率（r = -0.36）以及心率相对增加（r = 0.33）之间存在显著相关性。观察到 LOS 与哭闹时间之间的相关性（r = 0.37）。
PCA 与操作前及心率相对增加之间的相关性反映了心率的成熟性降低。LOS 对疼痛表达有影响，可能反映了累积“轻微”操作疼痛的影响。
