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在LISA中,非药物舒适护理可以取代芬太尼吗? 在NONA-LISA可行性研究

Niklas Breindahl^1,2,3, Tine Brink Henriksen^4,5, Christian Heiring^6,7

¹Department of Neonatal and Pediatric Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Niklas.breindahl@regionh.dk.

Pediatric research

|August 2, 2025

概括

使用COMFORTneo评分的标准化非药物舒适性护理对于少侵入性表面活性剂管理 (LISA) 是可行的. 这种方法,即使是用盐水代替芬太尼,也有效地管理了婴儿在手术期间的舒适度.

科学领域:

新生儿护理新生儿护理
呼吸系统药物呼吸系统药物
儿科麻醉学儿科麻醉学

背景情况:

在较少侵入性表面活性剂 (LISA) 管理期间最佳舒适度策略尚未明确.
这项研究评估了使用COMFORTneo评分对接受LISA的婴儿进行标准化的非药物舒适护理方法.
这项研究比较了芬太尼与LISA的盐水前期治疗.

研究的目的:

在LISA期间以COMFORTneo分数为指导的标准化非药物舒适护理的可行性进行评估.
为了比较芬太尼与盐水预药的疗效,在LISA期间保持婴儿舒适度.
评估在NONA-LISA试验中需要额外的止痛药和推迟同意的可行性.

主要方法:

一项随机对照试验,涉及在妊娠30周之前出生的婴儿接受LISA.
婴儿接受了静脉注射芬太尼或同位素盐水作为前期治疗.
标准化的非药物舒适性护理给了两个组,结果包括修改的COMFORTneo评分,需要开放式芬太尼,以及推迟同意纳入率.

主要成果:

17名婴儿被随机分配 (8个芬太尼,9个盐液),妊娠年龄中位数为28周.
修改后的COMFORTneo评分≥14发生在4/8 (芬太尼) 和3/9 (盐水) 婴儿中.
大多数高分数的病例都通过增强的非药物治疗来管理;盐水组中只有两个婴儿需要开放标签的芬太尼.

结论:

根据修改后的COMFORTneo评分指导,使用盐水和标准化的非药物舒适护理进行LISA是可行的和安全的.
增强的非药物舒适性护理足以管理大多数婴儿的手术不适,无论前期药物治疗如何.
这项研究表明了盲目的前期药物治疗和使用推迟同意招聘的可行性.

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