儿童外周静脉穿刺疼痛管理的最佳证据总结

Summary of best evidence for pain management of peripheral venipuncture in children

目的 总结儿童外周静脉穿刺疼痛管理的最佳证据,减轻儿童因外周静脉穿刺带来的疼痛体验。方法 计算机检索包括UpToDate、Cochrane Library、Joanna Briggs Institute Library、PubMed、Embase、EBSCO host、美国输液护士协会、国际疼痛研究学会、加拿大安大略注册护士协会、美国指南网、急诊护士协会、英国国家卫生与临床评价机构、苏格兰学院间指南网络、英国皇家护理、中国生物医学数据库、中国知网、万方数据库、维普。证据类型包括指南、系统评价、证据总结和临床最佳实践等。结果 从建立静脉治疗团队、执行疼痛评估、选择血管可视化技术、应用非药物干预措施、置管前使用麻醉药物、鼓励父母参与、护士参加在职继续教育7个方面共提取最佳证据14条。结论 儿科护士应充分考虑每一条证据是否具有可行性及适宜性,选择适合儿童发育水平的疼痛评估工具和实施相应的干预措施,减轻儿童外周静脉穿刺时的疼痛。

Objective To retrieve, evaluate, and summarize the best evidence on pain management of peripheral venipuncture in children and reduce their pain experience caused by peripheral venipuncture. Methods The relevant databases including UpToDate, Cochrane Library, Joanna Briggs Institute Library, PubMed, Embase, EBSCO host, American Association of Infusion Nurses, International Association for the Study of Pain, Registered Nurses’ Association of Ontario, National Guideline Clearinghouse, Emergency Nurses Association, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Royal College of Nursing, SinoMed, China National Knowledge Infrastructure, Wanfang Database, and VIP were searched by computor. The types of evidence included clinical practice guidelines, systematic reviews, evidence summaries, and clinical best practices. Results A total of 14 pieces of best evidence was integrated into 7 aspects: establishment of intravenous treatment team, execution of pain assessment, selection of vascular visualization technology, implement of non-pharmaceutical intervention measures, use of transdermal anesthetics before catheter insertion, encouragement of parental participation, and nurses’ participation in in-service continuing education.Conclusion Pediatric nurses should fully consider whether each piece of evidence is feasible and appropriate, select pain assessment tools suitable for children’s development level and implement corresponding intervention measures to relieve children’s pain during peripheral venipuncitation.