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新生儿经气管插管时的镇痛与镇静:综合文献回顾。

Analgesia and sedation for intratracheal intubation in the neonatal period: an integrative literature review.

机构信息

Pediatrician and Neonatologist, Master's student in Maternal and Child Health at Universidade Franciscana, Santa Maria, Brazil.

Nurse and Master in Maternal and Child Health at Universidade Franciscana, Santa Maria, Brazil.

出版信息

J Pediatr (Rio J). 2023 Mar-Apr;99(2):112-119. doi: 10.1016/j.jped.2022.10.003. Epub 2022 Nov 11.

Abstract

OBJECTIVE

to assess evidence available in the literature about the use of sedation and analgesia for intratracheal intubation of newborns.

DATA SOURCES

by means of an integrative literature review, the authors looked for evidence related to the theme from the last ten years, indexed in the Pubmed, Medline, Lilacs, Scielo, and Scopus databases, by combining the descriptors: newborn, intratracheal intubation, and analgesia. Articles in Portuguese, English, and Spanish that met the research purpose were included.

DATA SUMMARY

After applying the eligibility criteria, ten articles on the topic were obtained, predominantly narrative reviews, retrospective studies, observational studies, and only one non-randomized clinical trial, which characterizes the literature related to the topic as having a low level of scientific evidence. There is still no consensus in the literature on which medications and indications are for use in non-elective intubations, despite the ethical recommendation.

DISCUSSION

pain and its deleterious effects should not be neglected. Neonatal Intensive Care Units should have their own protocols regarding sedation and analgesia for intubation considering the individual characteristics of each patient. There is an ethical recommendation regarding the use of sedation and analgesia for intubation since it is a known painful procedure.

摘要

目的

评估有关为新生儿行气管内插管使用镇静和镇痛的文献证据。

资料来源

通过综合文献回顾,作者从过去十年中在 Pubmed、Medline、Lilacs、Scielo 和 Scopus 数据库中索引的与主题相关的证据中进行了搜索,方法是将以下术语结合起来使用:新生儿、气管内插管和镇痛。纳入了符合研究目的的葡萄牙语、英语和西班牙语文章。

资料概要

在应用纳入标准后,获得了 10 篇关于该主题的文章,主要是叙述性综述、回顾性研究、观察性研究,仅有一篇非随机临床试验,这表明与该主题相关的文献的科学证据水平较低。尽管有伦理建议,但在非选择性插管中使用哪些药物和适应证仍没有共识。

讨论

不应忽视疼痛及其有害影响。新生儿重症监护病房应根据每位患者的个体特征制定自己的镇静和镇痛插管方案。由于气管内插管是一种已知的疼痛操作,因此有使用镇静和镇痛的伦理建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/967d/10031350/ec3223069466/gr1.jpg

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