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新生儿程序性疼痛管理:一项叙述性综述。

Procedural pain management in neonates: A Narrative review.

作者信息

Khanna Sukul, Alhyan Pinki, Batra Prerna, Bhaskar Vikram

机构信息

Department of Intern, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

出版信息

Int J Crit Illn Inj Sci. 2024 Oct-Dec;14(4):221-228. doi: 10.4103/ijciis.ijciis_44_24. Epub 2024 Dec 23.

Abstract

Over the past three decades, awareness regarding pain management in neonates has risen significantly. It has been very well established that neonates can perceive, feel, and react to stimuli that cause pain and discomfort to them. Neonates admitted to neonatal intensive care units (NICUs) are repeatedly subjected to invasive treatments, most of which are painful. These procedures, nevertheless, are still performed, sometimes without sufficient analgesia. Exposure to frequent traumatic and painful procedures has been associated with several adverse effects such as altered brain growth and signs of internalization. Both inadequate and excessive analgesia during this period of rapid development may lead to profound neurodevelopmental outcomes. Ensuring the avoidance of pain in NICUs is a crucial obligation from both ethical and medical standpoints. Despite established international criteria, there is currently insufficient adherence to this criterion, highlighting the need for additional development in uniformly providing effective pain management to newborns in NICUs.

摘要

在过去三十年里,新生儿疼痛管理的意识显著提高。新生儿能够感知、感受并对给他们带来疼痛和不适的刺激做出反应,这一点已经得到充分证实。入住新生儿重症监护病房(NICU)的新生儿会反复接受侵入性治疗,其中大多数治疗都会带来疼痛。然而,这些操作有时仍在没有充分镇痛的情况下进行。频繁经历创伤性和疼痛性操作与多种不良影响有关,如大脑发育改变和内化迹象。在这个快速发育阶段,镇痛不足和过度都可能导致严重的神经发育后果。从伦理和医学角度来看,确保新生儿重症监护病房避免疼痛是一项至关重要的责任。尽管有既定的国际标准,但目前对这一标准的遵守仍不充分,这凸显了在为新生儿重症监护病房的新生儿统一提供有效疼痛管理方面需要进一步改进。

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