Service de Néonatologie, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.
Pediatrics. 2011 Jul;128(1):e63-70. doi: 10.1542/peds.2010-1287. Epub 2011 Jun 13.
The goal of this study was to compare the analgesic effect of sucrose with that of the combination of sucrose and the local anesthetic cream EMLA during venipuncture in preterm neonates.
This randomized, double-blind prospective study included infants younger than 37 weeks' gestational age during 1 routine venipuncture for blood sampling. Each child randomly received either sucrose plus application of a placebo cream (S group) or sucrose plus EMLA cream (S+E group) before venipuncture. Venipuncture-induced pain was assessed through videotapes of the procedures by using the Douleur Aiguë Nouveau-né (DAN) behavioral scale. Pain was assessed at 2 phases: during venipuncture (from needle introduction to its removal) and during the recovery period (30 seconds after needle removal). Pain scores over time and between treatments were compared by using repeated-measures analysis of variance.
The study included 76 children (37 in the S group, 39 in the S+E group). Mean (SD) DAN pain scores for the S group and the S+E group were 7.7 (2.1) and 6.4 (2.5), respectively, during venipuncture and 7.1 (2.8) and 5.7 (3.3) during the postinjection period. A significant time and treatment effect in favor of the S+E group was observed.
The combination of sucrose and EMLA cream revealed a higher analgesic effect than sucrose alone during venipuncture in these preterm infants.
本研究旨在比较蔗糖与局部麻醉乳膏 EMLA 联合应用于早产儿静脉穿刺时的镇痛效果。
这是一项随机、双盲前瞻性研究，纳入了 37 周以下胎龄的常规静脉采血的早产儿。每个患儿在静脉穿刺前随机接受蔗糖加安慰剂乳膏（S 组）或蔗糖加 EMLA 乳膏（S+E 组）。通过录像评估静脉穿刺过程中的疼痛，使用新生儿急性疼痛量表（DAN）进行评估。疼痛评估分为 2 个阶段：静脉穿刺期间（从进针到拔针）和恢复期间（拔针后 30 秒）。采用重复测量方差分析比较不同时间点和不同处理组之间的疼痛评分。
本研究共纳入 76 例患儿（S 组 37 例，S+E 组 39 例）。S 组和 S+E 组静脉穿刺期间的平均（标准差）DAN 疼痛评分分别为 7.7（2.1）和 6.4（2.5），注射后期间的评分分别为 7.1（2.8）和 5.7（3.3）。观察到时间和处理因素均对 S+E 组有利。
与单独使用蔗糖相比，蔗糖与 EMLA 乳膏联合应用在这些早产儿静脉穿刺时具有更高的镇痛效果。
