Division of Neonatology, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy.
Neonatology. 2013;104(4):255-9. doi: 10.1159/000353386. Epub 2013 Sep 21.
Newborns perceive pain, and several non-pharmacologic analgesic methods have been used during painful procedures. Activation of the neonatal somatosensory cortex, in association with a painful procedure without analgesia, has been demonstrated by two-channel near-infrared spectroscopy (NIRS).
To evaluate both cortical and behavioural responses of healthy term newborns to a painful procedure during two non-pharmacologic analgesic interventions, i.e. glucose solution and breastfeeding.
The effects of glucose and breastfeeding on pain-associated neonatal cortical activity were studied in two groups (n = 30) by multichannel NIRS during a heel prick. Cortical activation was identified by variations in oxygenated haemoglobin. Neonatal pain expression was assessed by a validated scale.
No significant variations in cortical activity emerged using glucose solution, whereas breastfed newborns showed widespread cortical activation. Breastfed neonates showed significantly less behavioural pain expression.
Glucose is associated with no significant cortical activation and may interfere with pain-associated response at the cortical level. Conversely, breastfeeding analgesia is associated with generalized cortical activation and may act by multisensory stimulation, possibly overwhelming pain perception.
新生儿能够感知疼痛，因此在进行有创操作时会采用多种非药物镇痛方法。双道近红外光谱（NIRS）技术已经证实，在没有使用镇痛药物的情况下，新生儿感觉皮层会因有创操作而被激活。
评估健康足月新生儿在接受两种非药物镇痛干预（葡萄糖溶液和母乳喂养）时，对有创操作的皮质和行为反应。
在足跟采血过程中，通过多通道 NIRS 技术，对两组（每组 30 例）新生儿进行研究，评估葡萄糖和母乳喂养对与疼痛相关的新生儿皮质活动的影响。通过氧合血红蛋白的变化来识别皮质激活。采用经过验证的量表评估新生儿的疼痛表现。
葡萄糖组未出现明显的皮质活动变化，而母乳喂养的新生儿则表现出广泛的皮质激活。母乳喂养的新生儿表现出的行为疼痛明显较少。
葡萄糖无明显的皮质激活作用，可能会干扰皮质水平的疼痛反应。相反，母乳喂养的镇痛作用与广泛的皮质激活有关，可能通过多感官刺激起作用，从而可能减轻疼痛感知。
