Consequences of inadequate analgesia during painful procedures in children.
Consequences of inadequate analgesia during painful procedures in children.
复制标题
儿童疼痛手术期间镇痛不足的后果。
DOI：
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复制
发表时间：
1998
影响因子：
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通讯作者：
N. Schechter
中科院分区：
文献类型：
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作者：
S. Weisman;B. Bernstein;N. Schechter
目的
探讨疼痛手术（骨髓穿刺、腰椎穿刺或两者）镇痛不足对后续手术疼痛的影响。
设计
一组癌症患者参加了一项安慰剂对照、随机化研究，该研究记录了口服经粘膜枸橼酸芬太尼对疼痛手术的疗效，并对与开放标签口服经粘膜芬太尼进行的后续手术相关的疼痛进行了评分。
参与者
21名接受诊断程序的儿童，他们曾参加过以前的研究。
干预
所有儿童在手术前都接受了15至20微克/公斤的经粘膜芬太尼口服;在手术结束时，他们被要求对相关疼痛进行评分。
结果
在小于8岁的儿童（n = 13）中，与接受活性药物治疗的儿童（n = 5）相比，在最初研究中接受安慰剂治疗的儿童（n = 8）在随后的每次手术中的平均疼痛评分始终较高。重复测量方差分析表明，这种差异具有统计学意义（P = .04）。年龄较大的儿童（n = 8）没有显示出这种模式。
结论
幼儿初次手术的镇痛不足可能会降低后续手术中充分镇痛的效果。
OBJECTIVE
To explore the effect of inadequate analgesia for painful procedures (bone marrow aspiration, lumbar puncture, or both) on the pain of subsequent procedures.
DESIGN
A cohort of patients with cancer who had participated in a placebo-controlled, randomized study that documented the efficacy of oral transmucosal fentanyl citrate for painful procedures rated the pain associated with subsequent procedures performed with open-label oral transmucosal fentanyl.
PARTICIPANTS
Twenty-one children undergoing diagnostic procedures who had been participants in previous study.
INTERVENTION
All children were given oral transmucosal fentanyl, 15 to 20 microgram/kg, prior to the procedure; at its conclusion they were asked to rate the associated pain.
RESULTS
In children younger than 8 years (n = 13), mean pain ratings during each subsequent procedure were consistently higher for those who had received placebo (n = 8) in the original study compared with those who had received the active drug (n = 5). A repeated-measures analysis of variance suggests that this difference is statistically significant (P = .04). Older children (n = 8) did not show this pattern.
CONCLUSION
Inadequate analgesia for initial procedures in young children may diminish the effect of adequate analgesia in subsequent procedures.