Department of Pediatrics, Amphia Hospital, Breda, Netherlands.
Pediatrics. 2012 Apr;129(4):657-63. doi: 10.1542/peds.2011-2173. Epub 2012 Mar 5.
The purpose of this trial was to investigate whether breast milk (either breastfed or bottle-fed) has a better analgesic effect than sucrose in newborns born at a postmenstrual age between 32 and 37 weeks.
We conducted a randomized controlled trial at a secondary care neonatal unit in the Netherlands on 71 preterm neonates (postmenstrual age at birth 32-37 weeks), undergoing heel lance with an automated piercing device. Newborns were randomly assigned to breast milk (either breastfed or bottle-fed) administered during heel lance or oral sucrose administered before heel lance. We assessed the Premature Infant Pain Profile (PIPP) score (range, 0-21) to investigate whether there was a difference in pain score between neonates receiving breast milk and those receiving sucrose solution.
There was no significant difference in mean PIPP score between neonates receiving breast milk (6.1) and those receiving sucrose (5.5), with a mean difference of 0.6 (95% confidence interval -1.6 to 2.8; P = .58).
From this study, it cannot be concluded that breast milk has a better analgesic effect than sucrose in late preterm infants. From the results, it follows with 95% confidence that the analgesic effect of breast milk is not >1.6 points better and not > 2.8 points worse on the PIPP scale (SD 3.7) than the analgesic effect of sucrose in late preterm infants.
本试验旨在研究对于孕龄 32 至 37 周的早产儿，母乳（母乳喂养或奶瓶喂养）与蔗糖相比是否具有更好的镇痛效果。
我们在荷兰的一家二级新生儿科进行了一项随机对照试验，纳入了 71 名接受足跟采血的早产儿（出生时孕龄为 32-37 周），采用自动化穿刺设备进行足跟采血。新生儿随机分配至足跟采血时接受母乳（母乳喂养或奶瓶喂养）或足跟采血前接受口服蔗糖。我们评估早产儿疼痛行为量表（PIPP）评分（范围 0-21 分），以了解接受母乳和蔗糖溶液的新生儿之间疼痛评分是否存在差异。
接受母乳的新生儿（6.1 分）和接受蔗糖溶液的新生儿（5.5 分）的平均 PIPP 评分无显著差异，平均差异为 0.6（95%置信区间 -1.6 至 2.8；P =.58）。
本研究不能得出母乳在晚期早产儿中比蔗糖具有更好的镇痛效果的结论。根据结果，可以有 95%的信心认为，母乳在晚期早产儿中的镇痛效果不比蔗糖好 1.6 分以上，也不比蔗糖差 2.8 分以上（PIPP 量表的标准差为 3.7）。
