Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates
Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates
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DOI：
10.1136/bmj.319.7222.1393
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发表时间：
1999-11-27
影响因子：
--
通讯作者：
Olivier-Martin, M
中科院分区：
文献类型：
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作者：
Carbajal, R;Chauvet, X;Olivier-Martin, M
目的评价和比较口服葡萄糖、蔗糖和奶嘴的镇痛效果。为了确定蔗糖和奶嘴的协同镇痛作用，设计随机前瞻性研究，采用经验证的行为急性疼痛评定量表，设置产科病房，参与者150名接受静脉穿刺的足月新生儿随机分配到六个治疗组中的一个：不治疗;安慰剂（2 ml无菌水）; 2 ml 30%葡萄糖; 2 ml 30%蔗糖;奶嘴;和2 ml 30%蔗糖随后奶嘴。静脉穿刺期间的（四分位数）疼痛评分为7（5-10），无治疗组; 7（6-10），安慰剂组5（3-7）为30%葡萄糖; 5（2-8）为30%蔗糖; 2（1-4）为奶嘴;和1（1-2）为30%蔗糖加奶嘴。30%葡萄糖、30%蔗糖、奶嘴和30%蔗糖加奶嘴与安慰剂（无菌水）比较的Mann-Whitney U检验P值分别为0.005、0.01、< 0.0001和< 0.0001。这些比较的组间疼痛评分中位数差异分别为2（95%置信区间1 - 4）、2（0 - 4）、5（4 - 7）和0（5 - 8），30%葡萄糖、30%蔗糖和30%蔗糖+奶嘴与奶嘴比较的P值分别为0.0001、0.001和0.06。这些比较组之间的差异中位数分别为3（2至5），3（1至5），和1（0至2），分别。结论nle的浓缩蔗糖和葡萄糖和奶嘴的镇痛效果在新生儿临床上是明显的，奶嘴是更有效的比甜的解决方案。与单独使用奶嘴相比，蔗糖和奶嘴的关联显示出得分较低的趋势。这些简单而安全的干预措施应广泛用于新生儿的小手术。
Objectives To assess and compare the analgesic effects of orally administered glucose and sucrose and pacifiers. To determine the synergistic analgesic effect of sucrose and pacifiers.Design Randomised prospective study with validated behavioural acute pain rating scale.Setting Maternity ward.Participants 150 term newborns undergoing venepuncture randomly assigned to one of six treatment groups: no treatment; placebo (2 ml sterile water); 2 ml 30% glucose; 2 ml 30% sucrose; a pacifier; and 2 ml 30% sucrose followed by a pacifier.Results Median (interquartile) pain scores during venepuncture were 7 (5-10) for no treatment; 7 (6-10) for placebo (sterile water); 5 (3-7) for 30% glucose; 5 (2-8) for 30%, sucrose; 2 (1-4) for pacifier; and 1 (1-2) for 30% sucrose plus pacifier. Mann-Whitney U test P values for comparisons of 30% glucose, 30% sucrose, pacifier, and 30% sucrose plus pacifier versus placebo (sterile water) were 0.005, 0.01, < 0.0001, and < 0.0001, respectively. Differences between group median pain scores for these comparisons were 2 (95% confidence interval 1 to 4), 2 (0 to 4), 5 (4 to 7), and 0 (5 to 8), respectively P values for comparisons of 30% glucose, 30% sucrose, and 30% sucrose plus pacifier versus pacifier were 0.0001, 0.001, and 0.06, respectively. Differences between group medians for these comparisons were 3 (2 to 5), 3 (1 to 5), and 1 (0 to 2), respectively.Conclusion nle analgesic effects of concentrated sucrose and glucose and pacifiers are clinically apparent in newborns, pacifiers being more effective than sweet solutions. The association of sucrose and pacifier showed a trend towards lower scores compared with pacifiers alone. These simple and safe interventions should be widely used for minor procedures in neonates.