Bueno Mariana, Ballantyne Marilyn, Campbell-Yeo Marsha, Estabrooks Carole A, Gibbins Sharyn, Harrison Denise, McNair Carol, Riahi Shirine, Squires Janet, Synnes Anne, Taddio Anna, Victor Charles, Yamada Janet, Stevens Bonnie
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Front Pain Res (Lausanne). 2023 Feb 7;4:1110502. doi: 10.3389/fpain.2023.1110502. eCollection 2023.
To determine the analgesic effectiveness of repeated sucrose administration for skin-breaking (SB) procedures over the Neonatal Intensive Care Unit (NICU) hospitalization of preterm infants.
Longitudinal observational study, conducted in four level III Canadian NICUs. Eligible infants were <32 weeks gestational age at birth, and <10 days of life at enrollment. Infants received 24% sucrose (0.12 ml) prior to all painful procedures. The Premature Infant Pain Profile - Revised (PIPP-R) was used at 30 and 60 seconds after a medically-required SB procedure as soon as possible after enrollment and weekly up to three additional times for scheduled procedures.
172 infants (57.3% male, gestational age 28.35 (±2.31) weeks) were included. The mean 30 s PIPP-R scores were 6.11 (±3.68), 5.76 (±3.41), 6.48 (±3.67), and 6.81 (±3.69) respectively; there were no statistically significant interactions of study site by time ( = 0.31) or over time ( = 0.15). At 60 s, mean PIPP-R scores were 6.05 (±4.09), 5.74 (±3.67), 6.19 (±3.7), and 5.99 (±3.76) respectively; there were no study site by time interactions ( = 0.14) or differences over time ( = 0.52). There was a statistically significant site difference in the effectiveness of sucrose at 30 and 60 seconds ( < 0.01).
Consistently low PIPP-R scores following a skin-breaking procedure indicated that the analgesic effectiveness of the minimal dose of sucrose was sustained over time in the NICU. Further research is required to determine the optimal combination of sucrose and other pain management strategies to improve clinical practice and the impact of consistent use of repeated use of sucrose on neurodevelopment.
确定在早产儿新生儿重症监护病房（NICU）住院期间，重复给予蔗糖对皮肤破损（SB）操作的镇痛效果。
在加拿大四个三级NICU进行纵向观察性研究。符合条件的婴儿出生时胎龄<32周，入组时出生<10天。婴儿在所有疼痛操作前接受24%蔗糖（0.12 ml）。在入组后尽快且每周最多额外进行三次预定操作后，在医学要求的SB操作后30秒和60秒使用修订版早产儿疼痛量表（PIPP-R）。
纳入172例婴儿（57.3%为男性，胎龄28.35（±2.31）周）。平均30秒PIPP-R评分分别为6.11（±3.68）、5.76（±3.41）、6.48（±3.67）和6.81（±3.69）；研究地点与时间之间（=0.31）或随时间变化（=0.15）均无统计学显著交互作用。在60秒时，平均PIPP-R评分分别为6.05（± 4.09）、5.74（±3.67）、6.19（±3.7）和5.99（±3.76）；研究地点与时间之间无交互作用（=0.14）或随时间变化的差异（=0.52）。在30秒和 60秒时，蔗糖的有效性存在统计学显著的地点差异（<0.01）。
皮肤破损操作后持续较低的PIPP-R评分表明，在NICU中，最小剂量蔗糖的镇痛效果随时间持续存在。需要进一步研究以确定蔗糖与其他疼痛管理策略的最佳组合，以改善临床实践以及重复使用蔗糖对神经发育的影响。
