NEONATAL FACIAL AND CRY RESPONSES TO INVASIVE AND NONINVASIVE PROCEDURES
NEONATAL FACIAL AND CRY RESPONSES TO INVASIVE AND NONINVASIVE PROCEDURES
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DOI：
10.1016/0304-3959(90)91142-6
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发表时间：
1990-09-01
期刊：
影响因子：
7.4
通讯作者：
CRAIG, KD
中科院分区：
文献类型：
--
作者：
GRUNAU, RVE;JOHNSTON, CC;CRAIG, KD
由于沟通方式有限，评估新生儿的疼痛很困难。目的是确定侵入性操作引起的哭泣和面部活动的行为反应是否可以与非侵入性触觉事件的反应区分开来。 36 名健康足月婴儿（平均年龄 2.2 小时）按平衡顺序接受了 3 种手术：肌肉注射、在脐带上涂抹三重染料以及用酒精擦拭大腿。发现手术对面部总活动和面部运动潜伏期有显着影响。由眉毛凸出、眼睛紧闭、鼻唇沟加深和张开嘴组成的一系列面部表情最常与侵入性手术相关。两种非侵入性手术之间的比较显示，大腿擦拭的面部活动更多，而脐带三重染料的应用最少。对哭泣的声学分析显示，不同手术之间的统计学差异仅体现在整个组的哭泣潜伏期和哭泣持续时间上。然而，接受两次手术哭泣的婴儿表现出更高的音调和更大的注射强度。旋律、发声困难或抖动没有显着差异。研究人员对这一领域的方法论困难进行了研究，包括选择分析哭声的标准，以及当某些婴儿并不总是哭时，对比不同条件引起的哭声的逻辑和统计挑战。结论是，面部表情、哭泣开始潜伏期短和第一次哭泣周期持续时间长是对急性侵入性操作的典型反应。
Evaluation of pain in neonates is difficult due to their limited means of communication. The aim was to determie whether behavioural reactions of cry and facial activity provoked by an invasive procedure could be discriminated from responses to non-invasive tactile events. Thirty-six healthy full-term infants (mean age 2.2 h) received 3 procedures in counterbalanced order: intramuscular injection, application of triple dye to the umbilical stub, and rubbing thigh with alcohol. Significant effects of procedure were found for total face activity and latency to face movement. A cluster of facial comprised of brow bulging, eyes squeezed shut, deepening of the naso-labial furrow and open mouth was associated most frequently with the invasive procedure. Comparisons between the 2 non-invasive procedures showed more facial activity to thigh swabbing and least to application of triple dye to the umbilical cord. Acoustic analysis of cry showed statistically significant differences across procedures only for latency to cry and cry duration for the group as a whole. However, babies who cried to two procedures showed higher pitch and greater intensity to the injection. There were no significant differences in melody, dysphonation, or jitter. Methodological difficulties for investigators in this area were examined, including criteria for the selection of cries for analysis, and the logical and statistical challenges of contrasting cries induced by different conditions when some babies to do not always cry. It was concluded that facial expression, in combination with short latency to onset of cry and long duration of first cry cycle typifies reaction to acute invasive procedures.