Ozdogan Tutku, Akman Ipek, Cebeci Dilsad, Bilgen Hulya, Ozek Eren
Ministry of Health Suleymaniye, Teaching Hospital, Turkey.
Pediatr Int. 2010 Apr;52(2):175-9. doi: 10.1111/j.1442-200X.2009.02921.x. Epub 2009 Jul 16.
The aim of the present study was to test analgesic effects of double- versus single-dose breast milk and compare this effect with efficacy of double- versus single-dose sucrose in a group of healthy term newborns during heel prick blood sampling.
Healthy newborns (n= 142) were consecutively allocated to one of the six groups: group 1, single-dose breast milk; group 2, single-dose sterile water; group 3, single-dose 12.5% sucrose; group 4, two doses breast milk; group 5, two doses sterile water; and group 6, two doses 12.5% sucrose before the heel prick. The medians for crying time and the pain scores according to the neonatal facial coding system were recorded.
Crying times were 117 s, 126 s, 82 s, 128 s, 117 s, and 95 s in groups 1-6, respectively (P= 0.053). The mean pain scores were 4.60, 5.82, 3.91, 4.94, 5, and 4.05 in groups 1-6, respectively (P= 0.068). There was a significant difference between the groups for mean pain scores at 1 min and 3 min. There was a significant difference between the single-dose sucrose group and single-dose sterile water group at 1 min (P= 0.002). The babies in the sucrose group were active awake, whereas the ones in the breast milk group were asleep before heel prick.
Two doses of sucrose solution were not superior to single-dose sucrose. Neither single nor double doses of breast milk were effective in relieving pain in neonates. Two milliliters breast milk does not reduce response to pain during minor painful procedures in term neonates even when two doses have been given. Further studies are needed.
本研究旨在测试单剂量与双剂量母乳的镇痛效果,并将其与单剂量和双剂量蔗糖在一组健康足月儿足跟采血时的疗效进行比较。
将142名健康新生儿连续分配到六组中的一组:第1组,单剂量母乳;第2组,单剂量无菌水;第3组,单剂量12.5%蔗糖;第4组,双剂量母乳;第5组,双剂量无菌水;第6组,足跟采血前双剂量12.5%蔗糖。记录根据新生儿面部编码系统得出的哭闹时间中位数和疼痛评分。
第1 - 6组的哭闹时间分别为117秒、126秒、82秒、128秒、117秒和95秒(P = 0.053)。第1 - 6组的平均疼痛评分分别为4.60、5.82、3.91、4.94、5和4.05(P = 0.068)。各小组在1分钟和3分钟时的平均疼痛评分存在显著差异。单剂量蔗糖组和单剂量无菌水组在1分钟时存在显著差异(P = 0.002)。蔗糖组的婴儿在足跟采血前清醒活跃,而母乳组的婴儿在足跟采血前处于睡眠状态。
两剂量蔗糖溶液并不优于单剂量蔗糖。单剂量和双剂量母乳在缓解新生儿疼痛方面均无效。即使给予两剂量,2毫升母乳在足月儿进行轻微疼痛操作时也不能减轻疼痛反应。需要进一步研究。