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产房(分娩室和产后病房)中的新生儿疼痛评估实践:我们可以改进!

Neonatal pain assessment practices in the maternity ward (delivery room and postpartum ward): We can improve!

作者信息

Calamy L, Walter-Nicolet E

机构信息

Emergency department, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.

Department of neonatology, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.

出版信息

Arch Pediatr. 2018 Nov;25(8):476-479. doi: 10.1016/j.arcped.2018.09.001. Epub 2018 Oct 16.

Abstract

BACKGROUND

Almost 20% of neonates experience pain during delivery or the period following birth.

AIM

To describe the practices of pain assessment in the maternity wards in the greater Paris area, France.

METHODS

An e-mail questionnaire was sent to each practitioner in the 96 maternity units in Île de France between December 2013 and February 2014.

RESULTS

In all, 63 (65%) questionnaires were completed. Pain was assessed in 43 (68%) maternity units, mostly using the French scale "échelle de douleur et d'inconfort du nouveau-né" (EDIN). In total, 20 maternity units (32%) reported no pain assessment, mainly because they considered it to be too time-consuming, or because they argued that no pain scale was adequate; they relied on clinical signs or on the obstetric history for assessing and treating pain. About 40% of the maternity units using the EDIN scale judged it unsuitable for evaluating pain in term neonates in maternity units.

CONCLUSION

This first regional study on pain assessment in the maternity ward showed that nearly two thirds of centers assessed pain. This rate may be overestimated because of the reporting method used. The EDIN scale is the most widely used tool but seems unsuitable especially for the delivery room setting. Studies should be conducted to test other tools for assessing neonatal pain in the delivery room.

摘要

背景

近20%的新生儿在分娩期间或出生后的一段时间内会经历疼痛。

目的

描述法国大巴黎地区产科病房的疼痛评估实践。

方法

2013年12月至2014年2月期间,向法兰西岛大区96个产科单位的每位从业者发送了一份电子邮件问卷。

结果

总共完成了63份(65%)问卷。43个(68%)产科单位进行了疼痛评估,大多使用法国的“新生儿疼痛与不适量表”(EDIN)。总共有20个产科单位(32%)报告未进行疼痛评估,主要是因为他们认为这太耗时,或者认为没有合适的疼痛量表;他们依靠临床体征或产科病史来评估和治疗疼痛。约40%使用EDIN量表的产科单位认为该量表不适用于评估产科足月新生儿的疼痛。

结论

这项关于产科病房疼痛评估的首次区域研究表明,近三分之二的中心进行了疼痛评估。由于所采用的报告方法,这一比例可能被高估。EDIN量表是使用最广泛的工具,但似乎并不适用,尤其是在产房环境中。应该开展研究以测试其他用于产房新生儿疼痛评估的工具。

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