Dusek Jiri, Simkova Eliska, Fendrstatova Eva, Sram Radim J, Kotouckova Hana, Voracek Jan
Neonatology Department, Ceske Budejovice Hospital, Bozeny Nemcove 54, 370 01 Ceske Budejovice, Czech Republic.
Faculty of Health and Social Sciences, University of South Bohemia, J. Boreckeho 1167, 370 11 Ceske Budejovice, Czech Republic.
Children (Basel). 2022 Oct 29;9(11):1659. doi: 10.3390/children9111659.
The aim of our study was to compare the analgesic/sedative effects of various fundus-related procedural pain management strategies on the risk of retinopathy in premature infants.
This was a prospective comparative study involving a total of 94 neonates randomized to three groups meeting the criteria for at-risk neonates. Ophthalmologic screening was performed to evaluate the outcome of three procedural pain management strategies. The intensity of pain over time during and after the screening examination was evaluated. At the same time, we also looked at the occurrence of vegetative symptoms and their influence by the chosen medication. Pain response was observed in all 94 neonates enrolled in the study. In group A, no pain treatment was given. Group B had a local anesthetic oxybuprocaine hydrochloride 0.4% introduced into both eyes immediately prior to the examination. Group C received oral clonidine. The study was conducted as a pilot project and aimed to clarify the problem so that a project with a higher proband representation could take place in the future. Consequently, we performed quantitative analysis of complete pain and vegetative functions, followed by a qualitative analysis of their internal components.
In our study, we identified the most considerable effects for all three groups, including NIPS (Neonatal Infant Pain Scale) responses immediately during and after the examination. The influence of vegetative functions is of a longer-term nature and increased values can be clearly demonstrated even six hours after the examination.
The current results identify and quantify differences among all three methods of pain treatment on the level of single variables. Their internal structures, however, can be analysed only qualitatively because of the small size of the analysed sample.
我们研究的目的是比较各种与眼底相关的程序性疼痛管理策略对早产儿视网膜病变风险的镇痛/镇静效果。
这是一项前瞻性比较研究，共纳入94例符合高危新生儿标准的新生儿，随机分为三组。进行眼科筛查以评估三种程序性疼痛管理策略的效果。评估筛查检查期间及之后不同时间点的疼痛强度。同时，我们还观察了自主神经症状的发生情况以及所选药物对其的影响。对纳入研究的94例新生儿均观察了疼痛反应。A组未进行疼痛治疗。B组在检查前立即将0.4%的局部麻醉药盐酸奥布卡因滴入双眼。C组口服可乐定。该研究作为一个试点项目进行，旨在阐明问题，以便未来能够开展一个具有更高样本量的项目。因此，我们对完整的疼痛和自主神经功能进行了定量分析，随后对其内部成分进行了定性分析。
在我们的研究中，我们确定了所有三组在检查期间及之后立即出现的最显著影响，包括新生儿婴儿疼痛量表（NIPS）反应。自主神经功能的影响具有较长的持续性，甚至在检查后6小时仍可明显显示出数值升高。
目前的结果确定并量化了三种疼痛治疗方法在单个变量水平上的差异。然而，由于分析样本量较小，只能对其内部结构进行定性分析。
