气道吸引术后新生儿疼痛的时间评估
Temporal assessment of neonatal pain after airway aspiration.
作者信息
Gimenez Isabelle Leandro, Rodrigues Rafaella Fintelman, Oliveira Marcella Campos de Faria, Santos Beatriz Alves Rezende, Arakaki Vanessa da Silva Neves Moreira, Santos Rosana Silva Dos, Peres Rodrigo Tosta, Sant'Anna Clemax Couto, Ferreira Halina Cidrini
机构信息
Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Departamento de Fisioterapia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
出版信息
Rev Bras Ter Intensiva. 2020 Mar;32(1):66-71. doi: 10.5935/0103-507x.20200011. Epub 2020 May 8.
OBJECTIVE
To temporally assess a painful stimulus in premature infants using 3 neonatal pain scales.
METHODS
A total of 83 premature infants were observed during airway aspiration by 3 evaluators (E1, E2 and E3) using 3 pain assessment scales (Neonatal Facial Coding System - NFCS; Neonatal Infant Pain Scale - NIPS; and Premature Infant Pain Profile - PIPP) at 5 time points: T1 (before airway aspiration), T2 (during airway aspiration), T3 (1 minute after airway aspiration), T4 (3 minutes after airway aspiration), and T5 (5 minutes after airway aspiration). Light's Kappa (agreement among examiners and among scales at each time point) and the McNemar test (comparison among time points) were used considering p < 0.05.
RESULTS
There was a significant difference between the 3 examiners for T1 and T2 using the 3 scales. In T3, pain was observed in 22.9%/E1, 28.9%/E2, and 24.1%/E3 according to the NFCS; 22.9%/E1, 21.7%/E2, and 16.9%/E3 according to the NIPS; and 49.4%/E1, 53.9%/E2, and 47%/E3 according to the PIPP. There was a difference between T1 and T3 using the 3 scales, except for 2 examiners for the PIPP (E2: p = 0.15/E3: p = 0.17). Comparing T4 and T5 to T1, there was no difference in the 3 scales.
CONCLUSION
Premature infants required at least 3 minutes to return to their initial state of rest (no pain).
目的
使用3种新生儿疼痛量表对早产儿的疼痛刺激进行时间性评估。
方法
3名评估人员（E1、E2和E3）在83名早产儿进行气道吸引期间，于5个时间点使用3种疼痛评估量表（新生儿面部编码系统-NFCS；新生儿婴儿疼痛量表-NIPS；早产儿疼痛量表-PIPP）进行观察：T1（气道吸引前）、T2（气道吸引期间）、T3（气道吸引后1分钟）、T4（气道吸引后3分钟）和T5（气道吸引后5分钟）。考虑p<0.05，使用Light's Kappa（各时间点检查人员之间以及量表之间的一致性）和McNemar检验（时间点之间的比较）。
结果
在T1和T2时，3名检查人员使用3种量表评估存在显著差异。在T3时，根据NFCS，E1观察到22.9%的疼痛，E2为28.9%，E3为24.1%；根据NIPS，E1为22.9%，E2为21.7%，E3为16.9%；根据PIPP，E1为49.4%，E2为53.9%，E3为47%。使用3种量表时，T1和T3之间存在差异，但PIPP的2名检查人员除外（E2：p=0.15/E3：p=0.17）。将T4和T5与T1比较，3种量表均无差异。
结论
早产儿至少需要3分钟才能恢复到初始休息状态（无疼痛）。
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