Environment and Sleep on Preterm Infant Pain Response

描述(申请人提供)：新生儿重症监护室中的早产儿 护理病房(NICU)经常遭受必要但痛苦的诊断和 治疗程序。反复痛苦手术的累积效应 对发育中的大脑可能具有更大的生物学和临床重要性 比之前认识到的要多。新生儿疼痛的研究主要集中在 通过研究健康、足月婴儿和 年龄较大、生理稳定的早产儿。声音之间的关系 以及NICU和早产儿觉醒(睡眠和醒来)中的光线水平 它们对疼痛的反应尚未被研究过。具体的 这项研究的目的是考察(A)声音(Lmax)和 在NICU中作为环境变量的光(英尺-蜡烛)水平，(B)觉醒 新生儿水平(睡眠和醒来模式的ALS状态评分)，以及(C) 生理和行为反应(心率、血氧饱和度、早产 治疗前后早产儿的婴儿疼痛状况(PIPP评分) 痛苦的刺激--必要的采血时的脚跟。两者都是即时的 对痛苦手术的反应和从手术中恢复的时间 (恢复到基线、术前生理和行为水平) 学习。这项研究还将检查两者之间的关系 脚后跟前2小时内的声音、光线和唤醒水平 手术和早产儿对疼痛的反应受妊娠的影响 年龄。102例早产儿方便抽样(分层两等分) 胎龄组：25-27周和34-36周)将在 新生儿重症监护室。对疼痛的生理反应将使用婴儿的床边进行测量 心肺监护仪和脉搏血氧饱和度计。声音和光线的级别将是 分别使用声表和光表收集。生理学和 收集、同步和存储环境数据将使用 计算机化数据采集系统。将使用常规方法分析数据 线性模型(GLM)和分层回归分析。长期目标 这项研究的目的是调查护理干预措施，使(A)最小化 婴儿对疼痛的急性生理和行为反应 住院新生儿的NICU环境和唤醒(睡眠/唤醒)模式， (B)改进重症早产儿疼痛评估技术， 最终，(C)减少长期的神经行为后遗症， 反复的疼痛体验。

DESCRIPTION (provided by applicant): Preterm neonates in the Neonatal Intensive Care Unit (NICU) frequently suffer necessary but painful diagnostic and therapeutic procedures. The cumulative effects of repeated painful procedures on the developing brain may be of greater biological and clinical importance than previously recognized. Pain research in neonates has focused primarily on behavioral and physiologic responses by studying health, full-term infants, and older physiologically stable preterm infants. The relationship between sound and light levels in the NICU and preterm infants' arousal (sleep and wake patterns) with their responses to pain has not been investigated. The specific aims of this study are to examine the relationship between (a) sound (Lmax) and light (foot-candles) levels as environmental variables in the NICU, (b) arousal level of neonates (Als State Score for sleep and wake patterns), and (c) physiologic and behavioral responses (heart rate, oxygen saturation, Premature Infant Pain Profile (PIPP) score) of preterm infants prior to and following a painful stimulus - a heelstick for necessary blood sampling. Both immediate responses to the painful procedure and time to recover from the procedure (return to baseline, pre-procedure physiological and behavioral levels) will be studied. This research will also examine whether the relationships between sound, light, and arousal levels in the 2 hours preceding the heelstick procedure and preterm infants' responses to pain are moderated by gestational age. A convenience sample of 102 preterm infants (stratified into two equal gestational age groups: 25-27 weeks and 34-36 weeks) will be observed in the NICU. Physiologic responses to pain will be measured using the infant's bedside cardiorespiratory monitor and pulse oximeter. Sound and light levels will be collected using sound and light meters, respectively. Physiologic and environmental data will be collected, synchronized, and stored using a computerized data acquisition system. Data will be analyzed using general linear models (GLMs) and hierarchical regression analyses. The long-term aims of this research are to investigate nursing interventions that (a) minimize infant acute physiologic and behavioral responses to pain by promoting optimal NICU environment and arousal (sleep/wake) patterns for hospitalized neonates, (b) to improve pain assessment techniques in critically ill preterm neonates, and ultimately, (c) to decrease long-term neurobehavioral sequelae of chronic, repetitive pain experiences.