接受诊断性鼓膜穿刺术的幼儿的疼痛管理
Pain management in young children undergoing diagnostic tympanocentesis.
作者信息
Shaikh Nader, Hoberman Alejandro, Kurs-Lasky Marcia, Rockette Howard E, Chandra Anita, Colborn D Kathleen, Hooper Emma G, Reis Evelyn Cohen
机构信息
University of Pittsburgh School of Medicine, and General Academic Pediatrics, Children's Hospital of Pittsburgh, 3414 Fifth Ave., Pittsburgh, PA 15213, USA.
出版信息
Clin Pediatr (Phila). 2011 Mar;50(3):231-6. doi: 10.1177/0009922810385677. Epub 2010 Nov 22.
OBJECTIVE
To describe the pain associated with diagnostic tympanocentesis and to gather preliminary data comparing the efficacy of 3 methods of pain reduction for tympanocentesis.
METHODS
In children 6 to 36 months of age undergoing tympanocentesis for acute otitis media, the authors measured pain and distress throughout all phases of the procedure and recovery using physiological (heart rate) and behavioral measures (cry duration, Global Mood Scale score, and pain visual analog scales). They compared--in a randomized controlled trial--3 pain reduction interventions: acetaminophen, acetaminophen plus codeine, and ibuprofen plus midazolam.
RESULTS
Heart rate increased throughout the procedure, peaking during needle aspiration. Children treated with acetaminophen alone had higher peak heart rates and Global Mood Scale scores during parts of the procedure.
CONCLUSIONS
Acetaminophen alone may not be as effective in reducing pain-related physiological and behavioral changes as acetaminophen plus codeine or ibuprofen plus midazolam during diagnostic tympanocentesis.
目的
描述与诊断性鼓膜穿刺术相关的疼痛，并收集初步数据以比较3种减轻鼓膜穿刺术疼痛方法的疗效。
方法
对于因急性中耳炎接受鼓膜穿刺术的6至36个月大儿童，作者使用生理指标（心率）和行为指标（哭闹持续时间、整体情绪量表评分和疼痛视觉模拟量表）测量了整个手术过程及恢复阶段的疼痛和痛苦程度。在一项随机对照试验中，他们比较了3种减轻疼痛的干预措施：对乙酰氨基酚、对乙酰氨基酚加可待因以及布洛芬加咪达唑仑。
结果
在整个手术过程中，心率升高，在针头抽吸时达到峰值。单独使用对乙酰氨基酚治疗的儿童在手术部分阶段的心率峰值和整体情绪量表评分更高。
结论
在诊断性鼓膜穿刺术中，单独使用对乙酰氨基酚在减轻与疼痛相关的生理和行为变化方面可能不如对乙酰氨基酚加可待因或布洛芬加咪达唑仑有效。
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