Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick
Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick
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DOI：
10.1136/archdischild-2012-302921
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发表时间：
2013-11-01
影响因子：
4.4
通讯作者：
Medina Malagon, Lorena
中科院分区：
文献类型：
--
作者：
Marin Gabriel, Miguel Angel;del Rey Hurtado de Mendoza, Beatriz;Medina Malagon, Lorena
目的探讨母乳喂养（BF）联合皮肤接触（SSC）与其他非药物镇痛方法对健康足月新生儿足跟采血的镇痛效果（采用新生儿疼痛量表（NIPS））。入选标准：健康足月新生儿，希望母乳喂养且在前60分钟内没有喂养。干预新生儿随机分为4组：母乳喂养SSC组（BF+SSC组）（n=35）;蔗糖+SSC组（蔗糖+SSC组）（n=35）; SSC组（n=33）;或蔗糖组（n=33）。3名观察者在3个时间点（t（0）：足跟穿刺前2 min; t（1）：足跟穿刺中; t（2）：足跟穿刺后2 min）观看录像并测量NIPS评分。结果BF+SSC组的NIPS评分中位数（1分）显著低于其他3组（2分、4分、4分）。BF+SSC组中中度至重度疼痛的新生儿百分比也较低。BF+SSC和蔗糖+SSC两组新生儿的哭闹率均显著低于SSC组。结论本研究表明，BF + SSC在健康足月新生儿足跟穿刺期间提供优于其他非药物镇痛的上级镇痛。试验注册号（ClinicalTrials.gov）：NCT 01576432
Objective To investigate the analgesic effect (measured with Neonatal Infant Pain Scale (NIPS)) of breastfeeding (BF) in addition to skin-to-skin contact (SSC) versus other methods of non-pharmacological analgesia during blood sampling through heel lance in healthy term neonates.Design Randomised controlled trial.Setting Tertiary level maternity ward.Patients One hundred thirty-six healthy term newborns. Inclusion criteria: healthy term neonates, wish to breastfeed and absence of feeding during the previous 60min.Intervention Neonates were randomly assigned to four groups: Group breastfed with SSC (BF+SSC Group) (n=35); Group sucrose with SSC (Sucrose+SSC Group) (n=35); SSC Group (n=33); or Sucrose Group (n=33). Babies were recorded with a video camera.Outcome measures Three observers watched the videos and measured NIPS score at three time points (t(0): 2min before heel prick; t(1): During heel prick; and t(2): 2min after the heel prick). The influences of non-pharmacological methods on crying time, percentage of crying while sampling, heart rate, number of attempts and duration of sampling were also studied.Results BF+SSC Group achieved a significant lower median NIPS score (value=1) compared with other groups (value=2, 4 and 4, respectively). The percentage of neonates with moderate-to-severe pain was also lower in the BF+SSC Group. Both groups BF+SSC and Sucrose+SSC achieved a significant lower percentage of crying compared with SSC Group.Conclusions This study suggests that BF in addition to SSC provides superior analgesia to other kinds of non-pharmacological analgesia in healthy term neonates during heel prick.Trial registration number (ClinicalTrials.gov): NCT01576432