坏死性小肠结肠炎早产儿的疼痛管理：一项国际专家共识声明。
Pain management in preterm infants with necrotizing enterocolitis: an international expert consensus statement.
作者信息
Ten Barge Judith A, van den Bosch Gerbrich E, Allegaert Karel, Bhatt Aomesh, Brindley Nicola, Byrne Dearbhla, Campbell-Yeo Marsha, Camprubi-Camprubi Marta, Cavallaro Giacomo, Durrmeyer Xavier, Embleton Nicholas, Eriksson Mats, Flint Robert B, Garrido Felipe, Giannì Maria Lorella, Giannoni Eric, Kitt Heather, Klerk Daphne, Kristjánsdóttir Guðrún, Amponsah Abigail Kusi, Lapillonne Alexandre, Martin Camilia R, Matyas Melinda, Norman Elisabeth, Ohja Shalini, Pirlotte Sofie, Del Rio Ruth, Roué Jean-Michel, Sevivas Catarina, Slater Rebeccah, Smits Anne, de Pipaon Miguel Saenz, Tauzin Manon, Ukkonen Tiina, Unal Sezin, Villamor Eduardo, Molloy Eleanor J, Simons Sinno H P
机构信息
Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
出版信息
Eur J Pediatr. 2025 May 14;184(6):342. doi: 10.1007/s00431-025-06168-8.
UNLABELLED
Necrotizing enterocolitis (NEC) is probably the most painful intestinal disease affecting infants born preterm. NEC is known to cause highly severe and prolonged pain that has been associated with adverse short- and long-term effects. However, research on pain management in infants with NEC is scarce. This is likely due to its low incidence and very acute occurrence. As a result, the optimal pain management for these vulnerable infants remains unknown, and analgesic therapy practices are highly variable. Therefore, we aimed to establish expert-based consensus recommendations on pain management for NEC. Experts of the European Society for Paediatric Research (ESPR) Special Interest Groups on Neonatal pain and NEC were invited to participate in two consensus meetings. Prior to the first hybrid consensus meeting, an online survey provided input for potential recommendations. During the consensus meetings, experts shared clinical expertise and voted on recommendations. An expert consensus statement, comprising nine recommendations on optimal pain assessment and pain treatment in infants with NEC, was developed. Expert recommendations included regular pain assessments with a neonatal pain scale with additional assessments on indication and pre-emptive administration of analgesic therapy (e.g., paracetamol and an opioid) in infants with NEC stage ≥ II.
CONCLUSION
This expert consensus statement provides clinical recommendations essential for any healthcare professional caring for premature infants with NEC. The recommended guidance this statement provides on pain management strategies is key to preventing and reducing pain in this vulnerable population.
WHAT IS KNOWN
• Necrotizing enterocolitis (NEC) is a very painful disease, making effective pain management essential. • Current pain management practices for infants with NEC are highly variable.
WHAT IS NEW
• This expert consensus statement provides recommendations on optimal pain assessment and pain treatment in infants with NEC. • These clinical recommendations may help better prevent pain in these vulnerable infants.
未标注
坏死性小肠结肠炎（NEC）可能是影响早产儿的最痛苦的肠道疾病。已知NEC会导致极其严重和持久的疼痛，且与短期和长期不良影响相关。然而，关于NEC患儿疼痛管理的研究很少。这可能是由于其发病率低且发病非常急。因此，这些脆弱婴儿的最佳疼痛管理方法仍然未知，镇痛治疗方法差异很大。因此，我们旨在制定基于专家共识的NEC疼痛管理建议。欧洲儿科研究学会（ESPR）新生儿疼痛和NEC特别兴趣小组的专家被邀请参加两次共识会议。在第一次混合共识会议之前，进行了一项在线调查，为潜在建议提供了意见。在共识会议期间，专家们分享了临床专业知识并对建议进行了投票。制定了一份专家共识声明，其中包括关于NEC婴儿最佳疼痛评估和疼痛治疗的九条建议。专家建议包括使用新生儿疼痛量表进行定期疼痛评估，并对NEC≥II期的婴儿进行额外的指征评估和镇痛治疗（如对乙酰氨基酚和阿片类药物）的预防性给药。
结论
本专家共识声明为任何照顾NEC早产儿的医护人员提供了重要的临床建议。本声明提供的关于疼痛管理策略的推荐指南是预防和减轻这一脆弱人群疼痛的关键。
已知信息
• 坏死性小肠结肠炎（NEC）是一种非常疼痛的疾病，有效的疼痛管理至关重要。
• 目前NEC患儿的疼痛管理方法差异很大。
新信息
• 本专家共识声明提供了关于NEC婴儿最佳疼痛评估和疼痛治疗的建议。
• 这些临床建议可能有助于更好地预防这些脆弱婴儿的疼痛。
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