Harrison Denise, Bueno Mariana
Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.
School of Nursing, The University of Ottawa, Ottawa, ON, Canada.
Pain Rep. 2023 Feb 16;8(2). doi: 10.1097/PR9.0000000000001064. eCollection 2023 Mar-Apr.
Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented.
To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice.
This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented.
Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needle-related procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist.
There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.
一直以来，据报道早产儿、患病新生儿、健康新生儿以及婴幼儿（2岁以下）的疼痛治疗并不充分，有效的治疗策略也未得到很好的实施。
介绍与针头相关操作过程中有效疼痛治疗策略的现有证据，并强调将证据转化为实践的相关举措。
本临床最新资讯聚焦于2022年国际疼痛研究协会“将疼痛知识转化为实践全球年”中针对新生儿、婴幼儿这一特定人群的情况。回顾了最佳证据，并介绍了可用于将证据转化为实践的现有知识转化策略和项目。
在常见的与针头相关的操作过程中，针对新生儿和小婴儿的有效策略包括在可行且符合文化习惯的情况下使用少量甜味溶液、母乳喂养或肌肤接触护理。此外，还可采用非营养性吸吮、体位摆放、襁褓包裹、轻柔触摸、辅助包裹和稳固抱持等策略。对于幼儿，相关证据较少，区分疼痛和痛苦具有挑战性。然而，针对与针头相关操作推荐的策略包括父母/照顾者进行直立稳固的舒适抱持、适合其年龄的分散注意力方法以及局部麻醉。有效的疼痛管理转化需要让家庭参与，在疼痛操作过程中需要给予家庭支持并赋予其安抚孩子的能力。目前存在旨在改善有效疼痛治疗实施情况的组织层面、全国范围和全球范围的举措。
有证据表明存在针对新生儿、婴幼儿的有效疼痛管理策略，并且正在付出巨大努力将知识转化为行动。
