摘要
目的:对吸吮无营养安慰剂、经口给予30%蔗糖溶液、局部应用Emla(?)和将任何二者联合应用在早产儿EPO皮下注射过程中的镇痛效果进行对比。方法:这是一项随机的、前瞻性的研究,共历时5个月。研究对象为出生时胎龄不足33周,已经生后8 d及需要注射EPO (每周皮下注射3次,连续6周)的新生儿。所有研究对象被随机分为4组:吸吮无营养安慰剂组(T),经口给予0.2-0.5 ml
Objective. -To compare the analgesic effects of non nutritive pacifier sucking, oral administration of a 30% saccharose solution, local application of Emla(?) and their association for subcutaneous injection of erythropoietin (EPO) in preterm infants. Methods. -Our study was a randomised, prospective study conducted over 5 months. Neonateswith a gestational age below 33 weeks of gestation and older than 8 days of life were included if they were treated with EPO (three subcutaneous injections per week during 6 weeks). For each consecutive EPO injection, patients were randomised between four groups of intervention: non nutritive pacifier sucking (T), oral administration of 0. 2 -0. 5 ml of a 30% saccharose solution with non nutritive pacifier sucking (S), local application of Emla?with non nutritive pacifier sucking (E), and oral administration of 0. 2 - 0. 5 ml of a 30% saccharose solution with local application of Emla?and with non nutritive pacifier sucking (S + E). Each child was its own control. Pain was assessed with the Newborn Acute Pain scale (DAN) and with the Neonatal Facial Coding System (NFCS) . Results. -Thirty-three neonates were included, representing 265 injections. Distribution was: 41 in group T, 71 in group E, 86 in group S and 67 in group E + S. Mean DAN and NFCS scores were statistically different between groups T, E and S. Analgesic effect of saccharose (- 1. 05) was greater than Emla(?) (-0. 56) . Used together, effects were adding up without potentialisation. Conclusion. -This study shows that the association of non nutritive pacifier sucking with oral administration of saccharose and local application of Emla(?) has a better analgesic effect than each of these three interventions alone for subcutaneous injection of EPO.
