Gray Peter H, Trotter Jane A, Langbridge Peter, Doherty Claire V
Department of Neonatology, Mater Mothers' Hospital, University of Queensland, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2006 Jan-Feb;42(1-2):10-3. doi: 10.1111/j.1440-1754.2006.00782.x.
To ascertain the extent to which neonatal analgesia was used in Australia for minor invasive procedures as an indicator of evidence-based practice in neonatology.
A cross-sectional telephone survey of hospitals in all Australian states and territories with more than 200 deliveries per year was carried out. Questions were asked regarding awareness of the benefits and the use of analgesia for minor invasive procedures in term and near term neonates. Analysis was undertaken according to state and territory, annual birth numbers and the level of neonatal nursery care available.
Data were available from 212 of 214 eligible hospitals. Of the total respondents, 51% and 70% respectively were aware of the benefits of sucrose and breast-feeding for neonatal analgesia. Eleven per cent of units administered sucrose before venepuncture and 25% of units used breast-feeding. Ten per cent of units used sucrose before heel prick with 49% utilizing breast-feeding. Expressed breast milk was used in 10% of units. Analgesia was given less frequently before intravenous cannulation compared to venepuncture and heel prick. Awareness and implementation of neonatal analgesia varied widely in the states and territories. There was a trend for hospitals providing a higher level of neonatal care to have a greater awareness of sucrose as an analgesic (P < 0.0001) and the use of sucrose for venepuncture (P = 0.029), heel prick (P = 0.025) and intravenous catheter insertion (P = 0.013). Similar trends were found on analysis according to birth number of the maternity units. Smaller units had a greater usage of breast-feeding as an analgesic for heel prick (P = 0.017).
Despite good evidence for the administration of sucrose and breast milk in providing effective analgesia for newborn infants, it is not widely used in Australia. It is imperative that the gap between research findings and clinical practice with regard to neonatal analgesia be addressed.
确定澳大利亚在进行小侵入性操作时新生儿镇痛的使用程度，以此作为新生儿学循证实践的一个指标。
对澳大利亚所有每年分娩量超过200例的州和领地的医院进行横断面电话调查。询问了关于足月儿和近足月儿小侵入性操作中镇痛的益处的知晓情况以及镇痛的使用情况。根据州和领地、年度出生人数以及可用的新生儿护理水平进行分析。
214家符合条件的医院中有212家提供了数据。在所有受访者中，分别有51%和70%知晓蔗糖和母乳喂养对新生儿镇痛的益处。11%的科室在静脉穿刺前给予蔗糖，25%的科室使用母乳喂养。10%的科室在足跟采血前使用蔗糖，49%的科室使用母乳喂养。10%的科室使用挤出的母乳。与静脉穿刺和足跟采血相比，静脉置管前给予镇痛的频率较低。新生儿镇痛的知晓和实施在各州和领地差异很大。提供更高水平新生儿护理的医院有更大可能性知晓蔗糖作为一种镇痛药（P < 0.0001）以及在静脉穿刺（P = 0.029）、足跟采血（P = 0.025）和静脉导管插入（P = 0.013）时使用蔗糖。根据产科单位的出生人数进行分析时也发现了类似趋势。较小的单位在足跟采血时更常使用母乳喂养作为镇痛药（P = 0.017）。
尽管有充分证据表明给予蔗糖和母乳可为新生儿提供有效的镇痛，但在澳大利亚并未广泛使用。必须解决新生儿镇痛研究结果与临床实践之间的差距。
