Ho Lai Ping, Ho Simone S M, Leung Doris Y P, So Winnie K W, Chan Carmen W H
Neonatal Unit, Prince of Wales Hospital, Hong Kong SAR, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
J Clin Nurs. 2016 Feb;25(3-4):472-82. doi: 10.1111/jocn.13075.
This study aimed to investigate the feasibility and efficacy of swaddling to control procedural pain among preterm infants.
Swaddling has been recommended for controlling neonatal pain. However, the feasibility for use is uncertain and insufficient evidence is available among preterm infants.
A two-arm randomised controlled trial with repeated measures.
The study was conducted in a 21-bed neonatal intensive care unit of a regional hospital in Hong Kong. Preterm infants who required heelstick procedure were eligible. Fifty-four preterm infants between 30-37 gestational weeks were randomly assigned to swaddling (n = 27) and control (standard care, n = 27) groups. Pain assessment was performed pre, during, immediate, two, four, six and eight minutes after heelstick procedure using the Premature Infant Pain Profile.
The mean Premature Infant Pain Profile scores were significantly reduced in the intervention group compared to the control group during, immediate, two, four, and six minutes after the heelstick procedure. The mean changes of heart rate and oxygen saturation in the intervention group were significantly lower than that of the control group at all measured time points. Notably, the swaddled infants quickly resumed to the baseline level at two minutes whereas the control group reached the stable state at an extended period of six minutes.
The findings show that swaddling is feasible and efficacious in controlling pain for heelstick procedure among preterm infants. No adverse effects were observed.
This article presents the feasibility and efficacy of swaddling as a non-pharmacological and non-invasive intervention to relieve pain during the heelstick procedures among preterm infants. Swaddling can contribute to control minor procedural pain in neonates as one of the simple, safe, cost effective, humanistic and natural analgesia alternatives.
本研究旨在探讨襁褓包裹法控制早产儿操作过程中疼痛的可行性和有效性。
襁褓包裹法已被推荐用于控制新生儿疼痛。然而，其使用的可行性尚不确定，且在早产儿中缺乏充分的证据。
双臂重复测量随机对照试验。
研究在香港一家地区医院有21张床位的新生儿重症监护病房进行。需要足跟采血操作的早产儿符合入选条件。54名孕龄在30 - 37周的早产儿被随机分为襁褓包裹组（n = 27）和对照组（标准护理，n = 27）。使用早产儿疼痛量表在足跟采血操作前、操作过程中、操作后即刻、2分钟、4分钟、6分钟和8分钟进行疼痛评估。
与对照组相比，干预组在足跟采血操作过程中、操作后即刻、2分钟、4分钟和6分钟时的平均早产儿疼痛量表得分显著降低。干预组在所有测量时间点的心率和血氧饱和度平均变化均显著低于对照组。值得注意的是，襁褓包裹组婴儿在2分钟时迅速恢复到基线水平，而对照组在6分钟的较长时间后才达到稳定状态。
研究结果表明，襁褓包裹法在控制早产儿足跟采血操作疼痛方面是可行且有效的。未观察到不良反应。
本文介绍了襁褓包裹法作为一种非药物、非侵入性干预措施在早产儿足跟采血操作中缓解疼痛的可行性和有效性。襁褓包裹法作为一种简单、安全、经济有效、人文且自然的镇痛方法之一，有助于控制新生儿轻微操作疼痛。
