McCullough S, Halton T, Mowbray D, Macfarlane P I
Department of Child Health, Rotherham General Hospital, Moorgate Road, Rotherham, South Yorkshire S60 2UD, UK.
Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F100-3. doi: 10.1136/adc.2006.110338. Epub 2007 Jul 18.
To determine whether lingual sucrose modifies the pain response to nasogastric tube insertion in preterm infants.
Randomised, double-blind, placebo controlled clinical trial.
Special care baby unit.
20 stable preterm infants who required nasogastric tube insertion for feeding, randomised on 51 occasions.
Lingual 24% sucrose or water placebo (0.5-2 ml varying with body weight) administered 2 min before nasogastric tube insertion.
Heart rate, oxygen saturation (SaO2), Neonatal Facial Coding Score and presence or absence of cry.
Infants who received sucrose demonstrated a significantly lower Neonatal Facial Coding Score during nasogastric tube passage compared with the placebo group (median 1 (range 0-4) vs 3 (0-4), p = 0.004). There was a trend for sucrose-treated infants to have little change in heart rate during nasogastric tube passage compared with the placebo group (mean (SD) -0.73 (23) vs +11 (17), p = 0.055). Mean SaO2 did not change significantly. Pain response measurements quickly returned to baseline after nasogastric tube insertion. Adverse effects, such as apnoea or oxygen desaturation, were few and occurred equally in each group.
Nasogastric tube insertion induces a pain response comparable with previously reported responses to heel lance in neonates. Single-dose lingual 24% sucrose is effective in reducing the behavioural and physiological pain response to nasogastric tube insertion in preterm infants and it appears to be safe.
确定口腔给予蔗糖是否能改变早产儿鼻胃管插入时的疼痛反应。
随机、双盲、安慰剂对照临床试验。
特殊护理婴儿病房。
20名需要插入鼻胃管进行喂养的稳定早产儿，共随机分组51次。
在插入鼻胃管前2分钟给予口腔24%蔗糖或水安慰剂（0.5 - 2毫升，根据体重而定）。
心率、血氧饱和度（SaO2）、新生儿面部编码评分以及是否哭闹。
与安慰剂组相比，接受蔗糖的婴儿在鼻胃管插入过程中的新生儿面部编码评分显著更低（中位数1（范围0 - 4）对3（0 - 4），p = 0.004）。与安慰剂组相比，接受蔗糖治疗的婴儿在鼻胃管插入过程中心率变化趋势较小（均值（标准差）-0.73（23）对 +11（17），p = 0.055）。平均SaO2无显著变化。鼻胃管插入后疼痛反应测量值迅速恢复至基线。不良反应，如呼吸暂停或血氧饱和度下降很少，且在每组中发生率相同。
鼻胃管插入引起的疼痛反应与先前报道的新生儿足跟采血的疼痛反应相当。单剂量口腔24%蔗糖可有效减轻早产儿鼻胃管插入时的行为和生理疼痛反应，且似乎是安全的。
