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早产儿视网膜病变筛查期间疼痛的多感官刺激疗法研究进展

Research progress on multisensory stimulation therapy for pain during retinopathy of prematurity screening.

作者信息

Tao Chunlan, He Chuan, Tang Jinghua, Li Yongli, Chen Yuqin

机构信息

Department of Neonatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

出版信息

Front Pediatr. 2025 Aug 20;13:1623188. doi: 10.3389/fped.2025.1623188. eCollection 2025.

Abstract

Retinopathy of prematurity (ROP) is a retinal disease characterized by abnormal vascular proliferation, primarily associated with premature delivery and low birth weight. Advances in perinatal and neonatal care have increased survival rates but have also contributed to a rising incidence of ROP, necessitating regular ROP screening. However, the screening procedure, which involves an eyelid speculum and ophthalmoscope, frequently induces pain. Given the potential adverse effects of pharmacological interventions, non-pharmacological pain management is essential. Multisensory stimulation (MSS), integrating auditory, olfactory, gustatory, and tactile stimuli, is recommended by guidelines due to its favorable safety profile and proven analgesic efficacy. This review synthesizes evidence regarding MSS for pain management during ROP screening, focusing on three aspects: operational definitions of MSS [tactile stimuli like non-nutritive sucking (NNS), auditory interventions such as white noise, and gustatory agents including 24% sucrose]. Analgesic mechanisms, particularly sensory pathway competition and endorphin release; and clinical efficacy, with meta-analyses demonstrating superior outcomes of combined interventions (white noise combined with NNS) compared to single-modal approaches. This review aims to provide evidence-based guidance for effectively implementing MSS strategies, ultimately minimizing procedural pain.

摘要

早产儿视网膜病变(ROP)是一种以异常血管增生为特征的视网膜疾病,主要与早产和低出生体重有关。围产期和新生儿护理的进步提高了存活率,但也导致ROP发病率上升,因此需要定期进行ROP筛查。然而,涉及眼睑撑开器和检眼镜的筛查程序经常会引起疼痛。鉴于药物干预的潜在不良反应,非药物性疼痛管理至关重要。多感官刺激(MSS)整合了听觉、嗅觉、味觉和触觉刺激,因其良好的安全性和已证实的镇痛效果而被指南推荐。本综述综合了有关ROP筛查期间使用MSS进行疼痛管理的证据,重点关注三个方面:MSS的操作定义[如非营养性吸吮(NNS)等触觉刺激、白噪声等听觉干预以及24%蔗糖等味觉剂];镇痛机制,特别是感觉通路竞争和内啡肽释放;以及临床疗效,荟萃分析表明联合干预(白噪声与NNS联合)比单模式方法有更好的效果。本综述旨在为有效实施MSS策略提供循证指导,最终将操作疼痛降至最低。

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本文引用的文献

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[Evidence-based guideline for neonatal pain management in China (2023)].《中国新生儿疼痛管理循证指南(2023年版)》
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Feb 15;25(2):109-127. doi: 10.7499/j.issn.1008-8830.2210052.
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Practical approaches to sedation and analgesia in the newborn.新生儿镇静和镇痛的实用方法。
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