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在早产婴儿PICC插入期间的疼痛:针不是唯一的问题
Funda Yavanoglu Atay1, Omer Guran1, Ozlem Sahin1
1Department of Neonatology, Umraniye Training and Research Hospital, Istanbul, Turkey.
概括
在外围插入中央导管 (PICC) 放置之前,温暖的povidone-iodine (PI) 应用显著减少了早产婴儿的疼痛. 这种方法还减少了手术的持续时间和注射针的尝试,这表明它是一种有价值的非药物治疗疼痛管理策略.
科学领域:
- 新生儿护理 新生儿护理
- 儿科疼痛管理 儿科疼痛管理
- 医疗器械插入器 医疗器械插入器
背景情况:
- 周围插入的中央导管 (PICC) 对需要长期静脉通道的早产婴儿至关重要.
- PICC安置涉及侵入性手术,可能会导致新生儿显著的疼痛和痛苦.
- 非药理性疼痛管理策略对于尽量减少易受伤害的婴儿群体的手术性疼痛至关重要.
研究的目的:
- 调查热波维- (PI) 应用在早产婴儿PICC安置期间减轻疼痛的疗效.
- 评估热PI应用是否影响PICC插入所需的持续时间和尝试数量.
- 评估温暖PI作为新生儿侵入性手术非药物治疗疼痛的组成部分.
主要方法:
- 一项前性随机对照试验,涉及早产婴儿 (怀孕32周之前出生),需要他们的第一个PICC.
- 使用温暖PI (W-PI组) 与室温PI (R-PI组) 进行皮肤消毒的比较.
- 使用新生儿疼痛,兴奋和镇静量表 (NPASS) 的疼痛评估在基线,皮肤准备期间和针头插入期间.
主要成果:
- 在W-PI和R-PI组之间,基线 (T0) 或针头插入 (T2) 的NPASS得分没有显著差异.
- 与W-PI组相比,R-PI组的皮肤准备 (T1) 期间的NPASS得分显著更高 (p=0.019).
- 与R-PI组相比,W-PI组的手术持续时间显著缩短,针头插入的尝试较少.
结论:
- 温暖的PI应用在早产婴儿PICC插入皮肤准备阶段减少疼痛是有效的.
- 在PICC安置等侵入性手术前,可以推热PI作为非药物治疗疼痛管理策略的组成部分.
- 使用温暖的PI可能会导致更高效,更少的创伤性PICC插入新生儿.
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