Pain management in newborns.
Pain management in newborns.
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DOI：
10.1016/j.clp.2014.08.010
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发表时间：
2014-12
影响因子：
2.1
通讯作者：
Anand KJ
中科院分区：
文献类型：
--
作者：
Hall RW;Anand KJ
有效的疼痛管理是早产儿和足月新生儿的理想护理标准，并可能潜在地改善他们的临床和神经发育结果。尽管目前可用的工具存在局限性，但仍应使用针对具体情况的、经过验证的、客观的疼痛方法对新生儿疼痛进行常规评估。减少侵入性手术，使用药物、行为或环境措施可用于控制新生儿疼痛。非药物疗法包括袋鼠式护理、便利收纳、非营养性吸吮、蔗糖和其他甜味剂、按摩和针灸疗法。它们用于引起急性、短暂性或轻度疼痛的手术，或作为中度或重度疼痛的辅助治疗。局部和局部麻醉药可以减轻因皮肤破裂或粘膜损伤引起的急性疼痛。阿片类药物是治疗剧烈疼痛的主要药物；吗啡和芬太尼是最常用的药物，尽管也有其他阿片类药物。非阿片类药物包括各种镇静剂和麻醉剂，主要用于通气新生儿的辅助治疗。对乙酰氨基酚、布洛芬和其他药物用于新生儿，尽管它们的有效性和安全性尚未得到证实。本文总结了在新生儿ICU实施有效疼痛管理方案的方法，以及与手术、术后和机械通气相关的新生儿疼痛和压力的实用方案。
Effective pain management is a desirable standard of care for preterm and term newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools. Reducing invasive procedures, and using pharmacological, behavioral or environmental measures can be used to manage neonatal pain. Non-pharmacologic approaches include kangaroo care, facilitated tucking, non-nutritive sucking, sucrose and other sweeteners, massage and acupuncture therapy. They are used for procedures causing acute, transient, or mild pain, or as adjunctive therapy for moderate or severe pain. Local and topical anesthetics can reduce the acute pain caused by skin-breaking or mucosa-injuring procedures. Opioids form the mainstay for treatment of severe pain; morphine and fentanyl are the most commonly used drugs, although other opioids are also available. Non-opioid drugs include various sedatives and anesthetic agents, mostly used as adjunctive therapy in ventilated neonates. Acetaminophen, ibuprofen and other drugs are used for neonates, although their efficacy and safety remains unproven. Approaches for implementing an effective pain management program in the Neonatal ICU are summarized, together with practical protocols for procedural, postoperative, and mechanical ventilation-associated neonatal pain and stress.
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影响因子：
168.9
作者：
Anand, KJS;Hall, RW;Barton, BA
通讯作者：
Barton, BA
影响因子：
5.2
作者：
Aguado-Lorenzo, Virginia;Weeks, Kevin;Arenas-Lopez, Sara
通讯作者：
Arenas-Lopez, Sara
影响因子：
1.7
作者：
Anderson, BJ;Pons, G;Boccard, E
通讯作者：
Boccard, E
影响因子：
105.7
作者：
ANAND, KJS;SIPPELL, WG;AYNSLEYGREEN, A
通讯作者：
AYNSLEYGREEN, A
影响因子：
8.8
作者：
Anand, KJS;Phil, D;Soriano, SG
通讯作者：
Soriano, SG