Department of Neonatology, Hospital Universitario 12 de Octubre, Instituto de investigación Hospital 12 de octubre (i+12), Madrid, Spain.
Department of Neonatology, Hospital Universitario Severo Ochoa, Madrid, Spain.
Acta Paediatr. 2018 Mar;107(3):436-441. doi: 10.1111/apa.14151. Epub 2017 Dec 19.
Repeated, ongoing exposure to pain influences the growth, cognitive and motor functions, behaviour, personality and neurodevelopment of preterm infants. We compared the analgesic effects of expressed breast milk (EBM) and 24% oral sucrose on preterm neonates during venipuncture.
This multicentre randomised, noninferiority, crossover trial focused on five neonatal university units in Madrid, Spain, from October 2013 to October 2014. It comprised 66 preterm infants born at less than 37 weeks and randomly split into two groups. They received either EBM or sucrose two minutes before venepuncture, together with nonnutritive sucking and swaddling, then the opposite procedure at a later point. Pain was measured with the premature infant pain profile (PIPP) and crying was also measured.
There were no statistically significant differences between the groups. The PIPP scores were seven (4-9) with breast milk and six (4-8.25) with sucrose (p = 0.28). The 11 infants born at under 28 weeks of age showed higher median scores of nine (9-14) for breast milk and four (4-7) for sucrose (p = 0.009).
EBM and 24% sucrose had the same analgesic effect during venipuncture in most of the preterm neonates, but sucrose worked better in extremely preterm infants.
反复、持续的疼痛暴露会影响早产儿的生长、认知和运动功能、行为、个性和神经发育。我们比较了母乳（EBM）和 24%口服蔗糖在早产儿静脉穿刺时的镇痛效果。
这是一项多中心、随机、非劣效性、交叉试验，于 2013 年 10 月至 2014 年 10 月在西班牙马德里的 5 个新生儿大学单位进行，纳入了 66 名胎龄小于 37 周的早产儿，随机分为两组。他们在静脉穿刺前 2 分钟接受 EBM 或蔗糖，同时进行非营养性吸吮和襁褓包裹，然后在稍后的时间进行相反的操作。使用早产儿疼痛评估工具（PIPP）测量疼痛，同时也测量哭泣。
两组之间没有统计学上的显著差异。母乳喂养的 PIPP 评分中位数为 7 分（4-9 分），蔗糖组为 6 分（4-8.25 分）（p=0.28）。11 名胎龄小于 28 周的婴儿母乳喂养的中位数评分较高，为 9 分（9-14 分），而蔗糖组为 4 分（4-7 分）（p=0.009）。
在大多数早产儿的静脉穿刺中，EBM 和 24%蔗糖具有相同的镇痛效果，但在极早产儿中，蔗糖效果更好。
