Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam; Faculty of Medicine, University Paris Descartes, Paris 75006, Ile-de-France, France.
Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
Pediatr Neonatol. 2020 Feb;61(1):106-113. doi: 10.1016/j.pedneo.2019.07.003. Epub 2019 Aug 8.
Newborns commonly experience pain due to a variety of reasons. Non-nutritive sucking (NNS) is thought to be an effective non-pharmacological method of pain-relief. However, the significant heterogeneity in some systematic reviews limited the certainty of the findings about NNS. Hence, this study was aimed at evaluating the analgesic effect and safety of NNS in healthy term neonates during the heel prick test, using the Neonatal Pain Agitation and Sedation Scale (N-PASS).
In this randomized controlled trial, 42 term infants were included: 22 infants in the intervention group (receiving NNS) and 20 infants in the control group (not receiving NNS). In the intervention group, neonates were given a silicone pacifier 120 s before, during, and 120 s after the heel puncture, while neonates in the control group received routine care. Pain-related outcomes were assessed using the N-PASS at 30s, 60s, 90s, and 120s after the heel prick. Any adverse events during the procedure were noted. The Spearman correlation coefficients between the pain scores on the N-PASS and two other scales (NFCS and NIPS) were calculated at all four moments of evaluation.
The mean N-PASS pain scores at 30s, 60s, 90s, and 120s after heel prick were significantly lower in the NNS group than in the control group: 4.73 ± 2.78 vs. 7.90 ± 1.52 (p = 0.0002); 3.64 ± 3.06 vs. 5.55 ± 2.95 (p = 0.052); 2.59 ± 3.08 vs. 5.25 ± 3.51 (p = 0.011); and 2.05 ± 2.94 vs. 4.90 ± 3.99 (p = 0.013), respectively. No adverse events were detected in either group. Our findings revealed a strong positive correlation between the pain scores on the N-PASS and two other scales (NFCS and NIPS), which was statistically significant (p < 0.01).
NNS is considered a safe and effective pain-relief method during the heel prick procedure in term neonates, demonstrated using the N-PASS. These findings were correlated with the pain evaluation by NFCS and NIPS.
新生儿由于各种原因经常会感到疼痛。非营养性吸吮（NNS）被认为是一种有效的非药物止痛方法。然而，一些系统评价中的显著异质性限制了 NNS 对疼痛缓解作用的确定性。因此，本研究旨在使用新生儿疼痛、激动和镇静评分（N-PASS）评估 NNS 在健康足月新生儿足跟采血试验中的镇痛效果和安全性。
在这项随机对照试验中，纳入了 42 名足月婴儿：22 名婴儿在干预组（接受 NNS），20 名婴儿在对照组（未接受 NNS）。在干预组中，新生儿在足跟穿刺前 120 秒、穿刺期间和穿刺后 120 秒给予硅酮奶嘴，而对照组新生儿接受常规护理。在足跟穿刺后 30 秒、60 秒、90 秒和 120 秒使用 N-PASS 评估与疼痛相关的结局。记录过程中的任何不良事件。在所有四个评估时刻，计算 N-PASS 疼痛评分与另外两个量表（NFCS 和 NIPS）之间的 Spearman 相关系数。
足跟穿刺后 30 秒、60 秒、90 秒和 120 秒，NNS 组的 N-PASS 疼痛评分明显低于对照组：4.73±2.78 与 7.90±1.52（p=0.0002）；3.64±3.06 与 5.55±2.95（p=0.052）；2.59±3.08 与 5.25±3.51（p=0.011）；2.05±2.94 与 4.90±3.99（p=0.013）。两组均未发现不良事件。我们的研究结果显示，N-PASS 疼痛评分与另外两个量表（NFCS 和 NIPS）之间存在很强的正相关，具有统计学意义（p<0.01）。
NNS 被认为是一种安全有效的足跟采血程序中的止痛方法，使用 N-PASS 进行评估。这些发现与 NFCS 和 NIPS 的疼痛评估相关。
