在婴儿耐火性疼痛和镇静治疗方面的挑战
Alexandra Oschman1, Karishma Rao2,3
1Department of Pharmacy, Children's Mercy Hospital, Kansas City, MO, United States.
Frontiers in pharmacology
|January 18, 2024
概括
在新生儿重症监护室 (NICU) 中医疗复杂的早产婴儿的疼痛和镇静的管理是具有挑战性的. 本综述探讨了耐火性疼痛,镇静管理以及这些脆弱婴儿的相关临床挑战.
科学领域:
- 新生儿科学 新生儿科学
- 儿科重症监护 儿科重症监护
- 药理学 药理学是指药理学的学科.
背景情况:
- 改善早产婴儿的存活率导致医疗复杂的婴儿增加,需要长时间的新生儿重症监护室 (NICU) 停留.
- 尽管新生儿护理取得了进展,但这些慢性NICU患者的疼痛和镇静的有效管理仍然是一个重大的临床挑战.
研究的目的:
- 总结有关慢性NICU患者耐火性疼痛和镇静的诊断和管理的当前文献.
- 为了突出临床医生在这个复杂的儿科群体中管理疼痛和镇静时所面临的挑战.
主要方法:
- 对新生儿和婴儿护理中疼痛和镇静管理现有研究的综合文献综述.
- 分析挑战,包括开发适当的评估尺度和临床医生对儿科疾病状态和药物治疗不熟悉的情况.
- 在耐药病例中探索阿片类药物诱导的过敏症 (OIH) 和痴呆症的潜在作用.
主要成果:
- 对于这一群体,需要开发经过验证的疼痛,镇静和戒断量表.
- 关于婴儿用 gabapentin,ketamine 和 risperidone 等药物治疗的安全性和疗效的数据有限.
- 阿片类药物诱导的过敏症 (OIH) 和妄想症经常被忽视,但可能会导致耐火性疼痛和镇静问题.
结论:
- 在慢性NICU婴儿中管理耐火性疼痛和镇静会带来多方面的挑战.
- 进一步的研究至关重要,以建立基于证据的指导方针,以便在这个脆弱人群中安全有效地使用药物治疗.
- 在对这些复杂的婴儿的综合护理中,应考虑解决OIH和妄症.
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