在接受呼吸器支持的早产新生儿中常规输注吗啡:一个随机对照试验
Sinno H P Simons1, Monique van Dijk, Richard A van Lingen
1Department of Pediatric Surgery, Erasmus MC-Sophia, Rotterdam, The Netherlands.
JAMA
|November 13, 2003
概括
在早产新生儿中持续输注吗啡并没有减少疼痛或改善神经系统的结果. 然而,它确实降低了腹腔内出血 (IVH) 的发生率. 需要对长期神经行为影响进行进一步的研究.
科学领域:
- 新生儿重症监护中心
- 儿科药理学 儿科药理学
- 临床试验研究 临床试验研究
背景情况:
- 新生儿重症监护室 (NICU) 将新生儿暴露在痛苦的刺激中.
- 在早产新生儿的疼痛管理中常规使用吗啡并不成熟.
研究的目的:
- 评估持续静脉注射吗啡输液对早产新生儿疼痛反应的影响.
- 为了评估吗啡对腹腔内出血 (IVH) 发生率和神经系统不良结果的影响.
主要方法:
- 一项随机,双盲,安慰剂对照试验,涉及150名新生儿在NICU接受呼吸.
- 长达7天的吗啡或安慰剂输注,评估疼痛得分和神经学结果.
主要成果:
- 吗啡组和安慰剂组之间疼痛评分没有显著差异.
- 吗啡输注降低了腹腔内出血 (IVH) 的发生率 (23%对40%,P=.04).
- 没有观察到对神经系统不良结果的显著影响.
结论:
- 常规的吗啡输注缺乏可测量的止痛效果,并且不会改善空气通风过早新生儿的神经结果.
- 虽然IVH发病率下降,但由于缺乏止痛效益,因此不支持常规使用.
- 长期的神经行为结果需要进一步调查.
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