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在足跟采血时,除了皮肤接触外,还可以进行母乳喂养来缓解疼痛。

Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick.

机构信息

Deparment of Pediatrics, Hospital Puerta de Hierro-Majadahonda, , Madrid, Spain.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2013 Nov;98(6):F499-503. doi: 10.1136/archdischild-2012-302921. Epub 2013 Jul 9.

Abstract

OBJECTIVE

To investigate the analgesic effect (measured with Neonatal Infant Pain Scale (NIPS)) of breastfeeding (BF) in addition to skin-to-skin contact (SSC) versus other methods of non-pharmacological analgesia during blood sampling through heel lance in healthy term neonates.

DESIGN

Randomised controlled trial.

SETTING

Tertiary level maternity ward.

PATIENTS

One hundred thirty-six healthy term newborns.

INCLUSION CRITERIA

healthy term neonates, wish to breastfeed and absence of feeding during the previous 60 min.

INTERVENTION

Neonates were randomly assigned to four groups: Group breastfed with SSC (BF+SSC Group) (n=35); Group sucrose with SSC (Sucrose+SSC Group) (n=35); SSC Group (n=33); or Sucrose Group (n=33). Babies were recorded with a video camera.

OUTCOME MEASURES

Three observers watched the videos and measured NIPS score at three time points (t0: 2 min before heel prick; t1: During heel prick; and t2: 2 min after the heel prick). The influences of non-pharmacological methods on crying time, percentage of crying while sampling, heart rate, number of attempts and duration of sampling were also studied.

RESULTS

BF+SSC Group achieved a significant lower median NIPS score (value=1) compared with other groups (value=2, 4 and 4, respectively). The percentage of neonates with moderate-to-severe pain was also lower in the BF+SSC Group. Both groups BF+SSC and Sucrose+SSC achieved a significant lower percentage of crying compared with SSC Group.

CONCLUSIONS

This study suggests that BF in addition to SSC provides superior analgesia to other kinds of non-pharmacological analgesia in healthy term neonates during heel prick.

摘要

目的

研究在健康足月新生儿足跟采血时,与皮肤接触(SSC)相比,皮肤接触联合母乳喂养(BF)与其他非药物镇痛方法(通过足跟刺采血)相比的镇痛效果(通过新生儿疼痛量表(NIPS)测量)。

设计

随机对照试验。

地点

三级水平的产科病房。

患者

136 名健康足月新生儿。

纳入标准

健康足月新生儿,希望母乳喂养,且在采血前 60 分钟内未进食。

干预措施

新生儿被随机分为四组:组 1 进行 BF 联合 SSC(BF+SSC 组)(n=35);组 2 给予 SSC 联合蔗糖(Sucrose+SSC 组)(n=35);组 3 仅进行 SSC(SSC 组)(n=33);或组 4 仅给予蔗糖(Sucrose 组)(n=33)。婴儿由摄像机记录。

结果测量

三位观察者观看视频并在三个时间点(t0:足跟刺前 2 分钟;t1:足跟刺时;t2:足跟刺后 2 分钟)测量 NIPS 评分。还研究了非药物方法对哭泣时间、采样时哭泣百分比、心率、尝试次数和采样持续时间的影响。

结果

BF+SSC 组的中位数 NIPS 评分(值=1)明显低于其他组(值=2、4 和 4)。BF+SSC 组中中重度疼痛的新生儿比例也较低。BF+SSC 组和 Sucrose+SSC 组的哭泣百分比均明显低于 SSC 组。

结论

本研究表明,与 SSC 相比,在健康足月新生儿足跟采血时,BF 联合 SSC 比其他种类的非药物镇痛更有效。

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