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使用非营养性吸吮和口服葡萄糖溶液缓解新生儿疼痛:一项随机对照试验。

Using non-nutritive sucking and oral glucose solution with neonates to relieve pain: a randomised controlled trial.

机构信息

Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan, China.

出版信息

J Clin Nurs. 2010 Jun;19(11-12):1604-11. doi: 10.1111/j.1365-2702.2009.03014.x. Epub 2010 Apr 7.

DOI:10.1111/j.1365-2702.2009.03014.x
PMID:20384669
Abstract

AIM

To compare the efficacies of non-nutritive sucking and glucose solution as pain-relief interventions for neonates undergoing a venipuncture procedure.

BACKGROUND

Neonates may be subjected to painful procedures. The individual efficacies of non-nutritive sucking or oral glucose solution used alone on pain-relief for neonates still remain controversial.

DESIGN

A randomised, parallel-group controlled trial was designed.

METHODS

A total of 105 neonates were randomly assigned to one of the three groups: non-nutritive sucking, glucose solution, or control group. When a neonate underwent a venipuncture during a newborn screening test, his/her pain manifestations were videotaped and subsequently measured using the Neonatal Infant Pain Scale. Both the stability analysis and the analysis of repeated relationships were performed by generalised estimating equations.

RESULTS

The level of pain was regressed over the study variables (time and group) and covariate (gestational age). Both the non-nutritive sucking and glucose solution groups had significantly lower pain scores than the control group during the venipuncture and recovery phases. Furthermore, non-nutritive sucking seemed to be more effective than glucose solution.

CONCLUSION

Nurses can use a pain assessment tool and the pain-relief intervention to improve the quality of neonatal care in clinical practice. This study indicates that either non-nutritive sucking or glucose solution can effectively decrease the level of pain.

RELEVANCE TO CLINICAL PRACTICE

If a painful procedure on neonates is inevitable, simple, convenient and effective pain-relief methods such as non-nutritive sucking or glucose solution can be provided alone. Based on a neonate's condition, nurses can provide 2 ml of 25% glucose solution through a syringe for a breastfeeding infant before an invasive procedure if nipple confusion is the concern.

摘要

目的

比较非营养性吸吮和葡萄糖溶液作为缓解新生儿静脉穿刺过程疼痛的干预措施的效果。

背景

新生儿可能会经历疼痛的过程。单独使用非营养性吸吮或口服葡萄糖溶液对缓解新生儿疼痛的个体疗效仍存在争议。

设计

采用随机、平行组对照试验设计。

方法

共 105 例新生儿随机分为三组:非营养性吸吮组、葡萄糖溶液组和对照组。当新生儿在新生儿筛查测试中进行静脉穿刺时,其疼痛表现被录像,并随后使用新生儿疼痛量表进行测量。使用广义估计方程进行稳定性分析和重复关系分析。

结果

疼痛程度随研究变量(时间和组)和协变量(胎龄)而回归。在静脉穿刺和恢复阶段,非营养性吸吮组和葡萄糖溶液组的疼痛评分均显著低于对照组。此外,非营养性吸吮似乎比葡萄糖溶液更有效。

结论

护士可以使用疼痛评估工具和疼痛缓解干预措施来提高临床实践中新生儿护理的质量。本研究表明,非营养性吸吮或葡萄糖溶液均可有效降低疼痛程度。

临床意义

如果对新生儿进行疼痛操作不可避免,可单独提供简单、方便、有效的疼痛缓解方法,如非营养性吸吮或葡萄糖溶液。如果担心乳头混淆,护士可以在有创操作前给母乳喂养的婴儿用注射器提供 2 毫升 25%的葡萄糖溶液。