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持续气道正压通气下对早产儿进行鼻咽吸引时口服葡萄糖和母乳的镇痛效果:一项双盲随机对照试验

Analgesic Efficacy of Oral Dextrose and Breast Milk during Nasopharyngeal Suctioning of Preterm Infants on CPAP: A Blinded Randomized Controlled Trial.

作者信息

Rodrigues Luvena, Nesargi Saudamini V, Fernandes Maneka, Shashidhar A, Rao Suman P N, Bhat Swarnarekha

机构信息

Department of Paediatrics, Goa Medical College and Hospital, Bambolim, Goa 403202, India.

Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India.

出版信息

J Trop Pediatr. 2017 Dec 1;63(6):483-488. doi: 10.1093/tropej/fmx017.

Abstract

Continuous positive airway pressure (CPAP) requires nasopharyngeal suctioning for airway patency, which is painful. Other procedures have used breast milk and 25% dextrose as analgesics. We aimed to compare their analgesic efficacy during nasopharyngeal suctioning in preterm neonates on CPAP. In this blinded randomized controlled trial, babies received 25% dextrose or breast milk orally. Pain before, during and after was assessed using the Premature Infant Pain Profile (PIPP) score. Analysis was done for 40 babies. The mean PIPP score in the 25% dextrose group during the procedure was 11.25 ± 2.73 and 13.2 ± 2.55 (p = 0.02) with the intervention and without. In the breast milk group the PIPP score during the procedure was 11.35 ± 3.05 and 13.45 ± 3.27 (p = 0.04); this difference persisted even after the procedure. There was no significant difference between the interventions. Both interventions significantly reduce pain. The analgesic effect of breast milk was sustained.

摘要

持续气道正压通气(CPAP)需要进行鼻咽部吸引以保持气道通畅,这会引起疼痛。其他方法使用母乳和25%葡萄糖作为镇痛药。我们旨在比较它们在CPAP治疗的早产儿进行鼻咽部吸引时的镇痛效果。在这项双盲随机对照试验中,婴儿口服25%葡萄糖或母乳。使用早产儿疼痛量表(PIPP)评分评估吸引前、吸引期间和吸引后的疼痛。对40名婴儿进行了分析。25%葡萄糖组在吸引过程中,干预时的平均PIPP评分为11.25±2.73,未干预时为13.2±2.55(p = 0.02)。在母乳组中,吸引过程中的PIPP评分为11.35±3.05,未干预时为13.45±3.27(p = 0.04);即使在吸引后这种差异仍然存在。两种干预措施之间没有显著差异。两种干预措施均能显著减轻疼痛。母乳的镇痛效果具有持续性。

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