在新生儿中放置外围插入的中央导管的疼痛治疗:系统性审查和元分析
Najla Tabbara1,2, Anna Taddio3, Elizabeth Uleryk4
1Department of Pharmacy, Mount Sinai Hospital, Toronto, Ontario.
Paediatrics & child health
|February 2, 2026
概括
在新生儿中,阿片类药物可能会减少在外围插入中央导管 (PICC) 放置期间的疼痛. 当地麻醉剂和乙氨基是无效的. 对于最佳的疼痛管理策略,需要进一步的研究.
科学领域:
- 新生儿护理 新生儿护理
- 疼痛管理 疼痛管理
- 医疗程序 医疗程序
背景情况:
- 周围插入的中央导管 (PICC) 放置是新生儿常见但痛苦的手术.
- 有效的疼痛管理对于减轻与早期疼痛暴露相关的负面后果至关重要.
- 对于接受PICC安置的新生儿,最佳的疼痛管理策略尚不清楚.
研究的目的:
- 在PICC安置期间对新生儿进行疼痛管理干预措施的益处和危害进行系统审查和元分析.
- 评估药理干预措施在减轻疼痛方面的有效性.
- 评估手术成功和与疼痛管理相关的不良事件.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析,截至2024年3月.
- 使用验证的单维和多维工具评估疼痛.
- 使用随机效应模型计算的聚合效应估计;证据确定性的GRADE评估.
主要成果:
- 与对照组相比,阿片类药物 (吗啡,雷米芬坦尼尔) 在减轻急性疼痛方面表现出有效性.
- 局部麻醉剂 (四甲) 和静脉注射乙氨基并没有显示显著的疼痛减轻.
- 在干预措施之间没有观察到程序成功或严重不良事件的显著差异.
结论:
- 在新生儿PICC安置期间,阿片类药物可能有效地控制疼痛.
- 局部麻醉剂和乙氨基目前没有证据支持这种适用性.
- 需要进一步的研究,以建立最佳的疼痛管理协议,以此程序.
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