Martakis Kyriakos, Hünseler Christoph, Thangavelu Kruthika, Kribs Angela, Roth Bernhard
Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany.
Neonatology. 2016;110(4):261-266. doi: 10.1159/000446172. Epub 2016 Jun 14.
There is insufficient information regarding acute pain reactions among premature infants with a gestational age of less than 26 weeks and no appropriate scale for pain measurement in this age group. We hypothesized that these infants present specific reactions to a standardized pain stimulus within the first 3 days of life.
Mixed-methods, prospective, open-label, single-arm, observational study. Routine capillary or peripheral blood takes were filmed. The model consisting of a baseline, a preparatory, an interventional and a return-to-baseline phase was filmed. After a pilot evaluation, experienced medical and nursing neonatal intensive care unit (NICU) staff analysed the videos.
Twenty infants with gestational ages ranging from 22 weeks and 3 days to 26 weeks (mean 24 weeks) were recruited. Nineteen infants showed pain reactions, with a mean latency of 8.3 s (range 2-30). The majority presented eye movements, changes of the breath pattern and a slight increase in the mean SpO2 value. A high degree of interrater and intrarater reliability was found.
Premature infants with a gestational age of up to 26 weeks can present a variety of discrete reactions as response to a pain stimulus within the first 72 h of life. Experienced NICU staff can perform a valid and reliable evaluation of these reactions.
关于孕周小于26周的早产儿急性疼痛反应的信息不足，且该年龄组没有合适的疼痛测量量表。我们假设这些婴儿在出生后的头3天内对标准化疼痛刺激会出现特定反应。
采用混合方法、前瞻性、开放标签、单臂观察性研究。对常规毛细血管或外周血采集过程进行拍摄。对包括基线期、准备期、干预期和恢复到基线期的模型进行拍摄。经过初步评估后，新生儿重症监护病房（NICU）经验丰富的医护人员对视频进行分析。
招募了20名孕周在22周零3天至26周（平均24周）之间的婴儿。19名婴儿表现出疼痛反应，平均潜伏期为8.3秒（范围为2 - 30秒）。大多数婴儿出现眼球运动、呼吸模式改变以及平均SpO2值略有升高。发现评分者间和评分者内的可靠性都很高。
孕周达26周的早产儿在出生后的头72小时内对疼痛刺激可能会出现各种不同的反应。经验丰富的NICU工作人员能够对这些反应进行有效且可靠的评估。
