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新生儿疼痛管理

Pain management in newborns.

作者信息

Hall Richard W, Anand Kanwaljeet J S

机构信息

Department of Pediatrics/Neonatology, University of Arkansas Hospital, 4305 West Markham Street, Little Rock, AR 72205, USA.

Department of Pediatrics/Critical Care Medicine, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, 50 North Dunlap Street, Room 352R, Memphis, TN 38103, USA.

出版信息

Clin Perinatol. 2014 Dec;41(4):895-924. doi: 10.1016/j.clp.2014.08.010. Epub 2014 Oct 7.

Abstract

As a standard of care for preterm/term newborns effective pain management may improve their clinical and neurodevelopmental outcomes. Neonatal pain is assessed using context-specific, validated, and objective pain methods, despite the limitations of currently available tools. Therapeutic approaches reducing invasive procedures and using pharmacologic, behavioral, or environmental measures are used to manage neonatal pain. Nonpharmacologic approaches like kangaroo care, facilitated tucking, non-nutritive sucking, sucrose, and others can be used for procedural pain or adjunctive therapy. Local/topical anesthetics, opioids, NSAIDs/acetaminophen and other sedative/anesthetic agents can be incorporated into NICU protocols for managing moderate/severe pain or distress in all newborns.

摘要

作为对早产/足月新生儿的一项护理标准,有效的疼痛管理可能会改善他们的临床和神经发育结局。尽管现有工具存在局限性,但仍使用针对具体情况、经过验证的客观疼痛评估方法来评估新生儿疼痛。采用减少侵入性操作并运用药物、行为或环境措施的治疗方法来管理新生儿疼痛。非药物方法,如袋鼠式护理、舒适包裹、非营养性吸吮、蔗糖等,可用于程序性疼痛或辅助治疗。局部/外用麻醉剂、阿片类药物、非甾体抗炎药/对乙酰氨基酚及其他镇静/麻醉剂可纳入新生儿重症监护病房的方案,用于管理所有新生儿的中度/重度疼痛或痛苦。

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