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对足月新生儿进行小手术时的镇痛音乐。

Music for pain relief of minor procedures in term neonates.

机构信息

Department of Pediatrics, Lincoln Medical & Mental Health Center, Bronx, NY, USA.

Department of Pediatrics/Neonatology, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Pediatr Res. 2024 Feb;95(3):679-683. doi: 10.1038/s41390-023-02746-4. Epub 2023 Aug 29.

Abstract

BACKGROUND

Music for neonatal pain has not been exclusively studied in term neonates in a well-designed trial compared to the standard of care. This study aims to assess the effectiveness of music intervention as an adjuvant in relieving acute pain in term newborns undergoing minor painful procedures.

METHODS

This randomized, controlled, blinded trial included any term neonate undergoing heel prick. Both control and intervention groups received oral sucrose 2 min before heel prick. Intervention group was exposed to 'Bedtime Mozart' lullaby recorded music via bedside speakers. Pain was measured using Neonatal Infant Pain Scale (NIPS) at 1-min intervals. Investigators were blinded using noise-canceling headphones that played random music.

RESULTS

A total of 100 neonates were enrolled. Mean gestational age was 39.2 weeks, and mean duration of the procedure was 113 s. Music group was found to have significantly lower pain scores [OR = 0.42 (0.31, 0.56), p < 0.001]. Baseline NIPS scores were similar across groups and there was no interaction effect between groups and time. When NIPS were categorized as pain and no pain, there continued to be statistically significant lower NIPS scores in the music group (p < 0.001).

CONCLUSION

Recorded music, in addition to sucrose, is efficacious in reducing pain, encouraging its use in term neonates.

IMPACT

Recorded music effectively reduces pain induced by minor procedures in term neonates. Clinical studies have shown that live and recorded music induces changes in vital signs and pain scores in the NICU's predominantly preterm population. Most of these studies were also conducted in the white ethnic population. Our study objectively proves reduction in pain scores by using recorded music in a randomized, controlled, blinded study of predominantly non-white, term neonates. Recorded music is effective in reducing acute pain in term neonates and can be widely used even in low-resource nurseries.

摘要

背景

与标准护理相比,尚未在精心设计的试验中专门研究足月新生儿的音乐缓解疼痛,本研究旨在评估音乐干预作为辅助缓解接受小痛苦操作的足月新生儿急性疼痛的有效性。

方法

这是一项随机、对照、盲法试验,纳入了所有接受足跟采血的足月新生儿。对照组和干预组新生儿均在足跟采血前 2 分钟口服蔗糖。干预组通过床边扬声器暴露于“睡前莫扎特”摇篮曲录制音乐中。疼痛使用新生儿疼痛评分量表(NIPS)在 1 分钟间隔内进行测量。研究人员通过播放随机音乐的降噪耳机进行盲法。

结果

共纳入 100 名新生儿。平均胎龄为 39.2 周,操作平均持续时间为 113 秒。结果发现音乐组疼痛评分显著降低[比值比(OR)=0.42(0.31,0.56),p<0.001]。两组的 NIPS 基线评分相似,且组间和时间间无交互作用。当 NIPS 分类为疼痛和无疼痛时,音乐组的 NIPS 评分仍显著较低(p<0.001)。

结论

除蔗糖外,音乐记录还能有效减轻疼痛,鼓励在足月新生儿中使用。

意义

记录音乐与蔗糖联合使用能有效减轻足月新生儿小操作引起的疼痛。临床研究表明,现场音乐和录制音乐可改变 NICU 中主要为早产儿的人群的生命体征和疼痛评分。这些研究大多也是在白种人群中进行的。我们的研究在以非白人为主的足月新生儿中进行了随机、对照、盲法研究,客观地证明了记录音乐可降低疼痛评分。记录音乐在减轻足月新生儿急性疼痛方面有效,即使在资源有限的托儿所也可广泛使用。

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