口服蔗糖和非营养性吸吮联合用于婴儿疼痛管理的疗效和安全性：系统评价和荟萃分析。

Efficacy and safety of combined oral sucrose and nonnutritive sucking in pain management for infants: A systematic review and meta-analysis.

机构信息

Department of Neonatology, Ya'an People's Hospital, Ya'an, Sichuan, China.

Department of Pediatrics, Ya'an People's Hospital, Ya'an, Sichuan, China.

出版信息

PLoS One. 2022 May 6;17(5):e0268033. doi: 10.1371/journal.pone.0268033. eCollection 2022.

BACKGROUND

Pain management is currently important in neonatal intensive care unit (NICU). The superiority in pain relief of the combined oral sucrose (OS) and nonnutritive sucking (NNS) to other single intervention has not been well established. The administration of sucrose has been considered to potentially induce adverse events, which has been controversial. This study aims to investigate the combined effects and safety in comparison with other single intervention methods, including NNS, OS alone, breast milk and oral glucose.

METHODS

We searched databases including Medline (via Pubmed), Embase (via Ovid), web of science, and Cochrane Library for randomized controlled trials from Jan 1, 2000 to Mar 31, 2021. The data were analyzed in the meta-analysis using Review manager Version 5.3. Pain score was the primary outcome in this meta-analysis. The adverse events were assessed qualitatively.

RESULTS

A total of 16 studies were eligible in the meta-analysis. The results demonstrated a significant reduction in pain score in the NNS+OS group compared with NNS alone (SMD = -1.69, 95%CI, -1.69,-0.65) or sucrose alone (SMD = -1.39, 95% CI, -2.21,-0.57) during the painful procedures. When compared NNS+OS with breast milk, no significant difference was detected (SMD = -0.19, 95% CI: -0.5, 0.11).

CONCLUSION

The combined effects of NNS and OS might be superior to other single intervention method. However, the effects might be mild for moderate-to-severe pain.

背景

疼痛管理目前在新生儿重症监护病房（NICU）中很重要。联合口服蔗糖（OS）和非营养性吸吮（NNS）缓解疼痛的优势相对于其他单一干预措施尚未得到充分证实。给予蔗糖已被认为可能会引起不良反应，这一直存在争议。本研究旨在比较联合 OS 和 NNS 与其他单一干预方法（包括 NNS、OS 单独、母乳和口服葡萄糖）的联合作用和安全性。

方法

我们检索了包括 Medline（通过 Pubmed）、Embase（通过 Ovid）、Web of Science 和 Cochrane Library 在内的数据库，以获取 2000 年 1 月 1 日至 2021 年 3 月 31 日的随机对照试验。使用 Review Manager Version 5.3 对数据进行荟萃分析。疼痛评分是该荟萃分析的主要结局。不良事件定性评估。

结果

共有 16 项研究符合荟萃分析标准。结果表明，与 NNS 单独组（SMD=-1.69，95%CI：-1.69，-0.65）或蔗糖单独组（SMD=-1.39，95%CI：-2.21，-0.57）相比，NNS+OS 组在疼痛操作期间疼痛评分显著降低。与母乳相比，NNS+OS 组之间未检测到显著差异（SMD=-0.19，95%CI：-0.5，0.11）。