Boyle E M, Freer Y, Khan-Orakzai Z, Watkinson M, Wright E, Ainsworth J R, McIntosh N
University Medical Centre, Department of Pediatrics, Room 4G40, 1200 Main Street West, Hamilton, Ontario L8S 4J9, Canada.
Arch Dis Child Fetal Neonatal Ed. 2006 May;91(3):F166-8. doi: 10.1136/adc.2005.087668. Epub 2006 Jan 20.
Screening is necessary for infants at risk of retinopathy of prematurity. Despite local anaesthetic drops, infants find eye examinations distressing, displaying behavioural and physiological changes indicating acute pain. Oral sucrose and non-nutritive sucking reduce pain responses associated with invasive procedures.
To evaluate the use of oral sucrose and/or pacifier for reducing pain responses during eye examinations.
Forty infants <32 weeks gestation or <1500 g birth weight, in two neonatal units, were randomised to one of four interventions administered two minutes before their first screening examination: 1 ml sterile water as placebo (group 1, n = 10), 1 ml 33% sucrose solution (group 2, n = 10), 1 ml sterile water with pacifier (group 3, n = 9), or 1 ml 33% sucrose solution with pacifier (group 4, n = 11). Examinations were videotaped. Two observers, blind to the intervention, assessed recordings. Pain responses were scored using the premature infant pain profile (PIPP).
The groups were similar in gestation, birth weight, and age at examination. Mean PIPP scores were 15.3, 14.3, 12.3, and 12.1 for groups 1, 2, 3, and 4 respectively. Analysis of variance showed a significant difference in PIPP score between groups (p = 0.023). Infants randomised to pacifiers scored lower than those without pacifiers (p = 0.003). There was no difference between groups receiving sucrose and those receiving water (p = 0.321).
Non-nutritive sucking reduced distress responses in infants undergoing screening for retinopathy of prematurity. The difference in response was large enough to be detected by a validated assessment tool. No synergistic effect of sucrose and pacifier was apparent in this group.
对有早产儿视网膜病变风险的婴儿进行筛查很有必要。尽管使用了局部麻醉滴眼液，但婴儿仍觉得眼部检查令人痛苦，表现出行为和生理变化，表明存在急性疼痛。口服蔗糖和非营养性吸吮可减少与侵入性操作相关的疼痛反应。
评估口服蔗糖和/或安抚奶嘴在眼部检查期间减轻疼痛反应的作用。
在两个新生儿病房中，将40名孕周<32周或出生体重<1500克的婴儿随机分为四组，在首次筛查检查前两分钟给予以下四种干预措施之一：1毫升无菌水作为安慰剂（第1组，n = 10）、1毫升33%蔗糖溶液（第2组，n = 10）、含安抚奶嘴的1毫升无菌水（第3组，n = 9）或含安抚奶嘴的1毫升33%蔗糖溶液（第4组，n = 11）。检查过程进行录像。两名对干预措施不知情的观察者评估录像。使用早产儿疼痛量表（PIPP）对疼痛反应进行评分。
四组婴儿在孕周、出生体重和检查时的年龄方面相似。第1、2、3和4组的平均PIPP评分分别为15.3、14.3、12.3和12.1。方差分析显示各组间PIPP评分存在显著差异（p = 0.023）。随机分配到使用安抚奶嘴组的婴儿评分低于未使用安抚奶嘴组（p = 0.003）。接受蔗糖组和接受水组之间没有差异（p = 0.321）。
非营养性吸吮可减轻接受早产儿视网膜病变筛查的婴儿的痛苦反应。这种反应差异足够大，可通过经过验证的评估工具检测到。在该组中，蔗糖和安抚奶嘴没有明显的协同作用。
