PEDEGO Research Unit, and Medical Research Center Oulu, University of Oulu, Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
PEDEGO Research Unit, and Medical Research Center Oulu, University of Oulu, Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
J Pediatr. 2016 Jan;168:36-40. doi: 10.1016/j.jpeds.2015.08.003. Epub 2015 Aug 29.
To determine whether intravenous paracetamol therapy is effective in pain therapy in premature infants.
From June 2009 to December 2011, 108 infants born very low gestational age (<32 weeks) (VLGA) were given intravenous paracetamol before the age of 72 hours. The loading dose was 20 mg/kg followed by 7.5 mg/kg every 6 hours. One hundred ten VLGA infants admitted from October 2007 to May 2009 formed the comparison group who received no paracetamol. Intravenous morphine was exclusively used as the opiate. Morphine dosage was calculated as the cumulative dose administered during the neonatal intensive care unit period. Pain symptoms were screened using pain scale scoring Neonatal Infant Acute Pain Assessment Scale. The number of apneas during the neonatal intensive care unit stay, and ventilation days per patient, were calculated.
The mean (SD) total number of paracetamol doses per patient was 16.9 (11.7), and the postnatal age for the first dose was 13.3 (13.8) hours. Infants in the paracetamol group needed significantly fewer morphine doses per patient than the comparisons, 1.78 (4.56) doses vs 4.35 (11.53), P = .044. The exposed had lower cumulative morphine dosage 0.17 (0.45) mg/kg vs 0.37 (0.96) mg/kg, P = .047. There were no differences in the Neonatal Infant Acute Pain Assessment Scale scores, or the numbers of apneas, or ventilation days. There was no evidence of adverse events including hepatic toxicity.
The need for morphine decreased significantly after the introduction of paracetamol for the VLGA infants.
确定静脉用对乙酰氨基酚疗法在早产儿疼痛治疗中的效果。
2009 年 6 月至 2011 年 12 月，对 108 名极低出生体重儿（VLGA）在 72 小时内给予静脉用对乙酰氨基酚。负荷剂量为 20mg/kg，随后每 6 小时给予 7.5mg/kg。2007 年 10 月至 2009 年 5 月收治的 110 名 VLGA 婴儿作为对照组，未给予对乙酰氨基酚。静脉用吗啡作为阿片类药物。吗啡剂量计算为新生儿重症监护期间给予的累积剂量。疼痛症状采用新生儿急性疼痛评估量表（NIPS）进行评分筛查。计算新生儿重症监护期间的呼吸暂停次数和每位患者的通气天数。
每位患者的对乙酰氨基酚总剂量平均（SD）为 16.9（11.7）次，首次剂量的出生后年龄为 13.3（13.8）小时。与对照组相比，对乙酰氨基酚组每位患者所需的吗啡剂量明显减少，分别为 1.78（4.56）剂量和 4.35（11.53）剂量，P=0.044。暴露组的累积吗啡剂量也较低，分别为 0.17（0.45）mg/kg 和 0.37（0.96）mg/kg，P=0.047。两组新生儿急性疼痛评估量表评分、呼吸暂停次数或通气天数无差异。没有证据表明有不良事件发生，包括肝毒性。
VLGA 婴儿引入对乙酰氨基酚后，吗啡的需求显著减少。
