新生儿接受右美托咪定后的疼痛和心率变异性。
Pain and heart rate variability in neonates receiving dexmedetomidine.
机构信息
Neonatology, BCNatal, Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clinic, University of Barcelona, Barcelona, Spain.
Neonatology, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), RICORS, Santiago de Compostela, Spain.
出版信息
J Perinatol. 2024 Nov;44(11):1669-1674. doi: 10.1038/s41372-024-02053-8. Epub 2024 Jul 20.
INTRODUCTION
Neonates in a NICU experience pain. Based on the cardiovascular and nociceptive systems link, a Newborn Infant Parasympathetic Evaluation (NIPE) monitor was designed to assess pain. The use of α-agonists as analgesic-sedative drugs has increased in neonates. Given their effect on the autonomic system, we hypothesized that their use may alter NIPE's measurement capacity.
METHODS
Data were prospectively collected. The included patients were evaluated using combined pain assessment systems.
RESULTS
Sixteen newborns requiring sedoanalgesia underwent a total of 84 pain assessments. A good correlation was found between the NIPE-index and the COMFORT-neo and the crSO2 (cerebral regional oxygen saturation). No correlation was found in premature infants. By sedation group, the correlation remained in those receiving αagonist.
CONCLUSION
NIPE is a reliable tool for pain assessment. Further studies in premature infants are needed. The use of αagonist does not alter the measuring capacity of NIPE. The correlation between NIPE-index and crSO2 was also demonstrated.
介绍
新生儿在新生儿重症监护病房（NICU）中会经历疼痛。基于心血管和伤害性感受系统的联系，设计了新生儿副交感神经评估（NIPE）监测仪来评估疼痛。在新生儿中，α-激动剂作为镇痛-镇静药物的使用有所增加。鉴于它们对自主神经系统的影响，我们假设它们的使用可能会改变 NIPE 的测量能力。
方法
前瞻性收集数据。使用联合疼痛评估系统对纳入的患者进行评估。
结果
16 名需要镇静镇痛的新生儿共进行了 84 次疼痛评估。NIPE 指数与 COMFORT-neo 和脑区域性氧饱和度（crSO2）之间存在良好的相关性。早产儿中未发现相关性。按镇静分组，在接受α激动剂的患者中仍存在相关性。
结论
NIPE 是一种可靠的疼痛评估工具。需要进一步研究早产儿。α激动剂的使用不会改变 NIPE 的测量能力。还证明了 NIPE 指数与 crSO2 之间的相关性。
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