Artículos de revistas
The Frequency Of Pharmacological Pain Relief In University Neonatal Intensive Care Units
Registro en:
Jornal De Pediatria. , v. 81, n. 5, p. 405 - 410, 2005.
217557
10.2223/JPED.1392
2-s2.0-31144479309
Autor
Prestes A.C.Y.
Guinsburg R.
Balda R.C.X.
Marba S.T.M.
Rugolo L.M.S.S.
Pachi P.R.
Bentlin M.R.
Institución
Resumen
Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU. Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0. Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion: It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice. Copyright © 2005 by Sociedade Brasileira de Pediatria. 81 5 405 410 Mather, L., Mackie, J., The incidence of postoperative pain in children (1983) Pain, 15, pp. 271-282 Anand, K.J., Craig, K.D., New perspectives on the definition of pain (1996) Pain, 67, pp. 3-6 Sabrine, N., Sinha, S., Pain in neonates (2000) Lancet, 355, pp. 932-933 Prestes, A.C., (2004) Epidemioiogia da dor Aguda em Unidades de Terapia Intensiva Neonatal Universitárias: Freqüência da Realização de Procedimentos Dolorosos e do Emprego de Analgésicos por via Sistêmica, , [dissertação]. São Paulo (SP): Universidade Federal de São Paulo Simons, S.H., Van Dijk, M., Van Lingen, R.A., Roofthooft, D., Duivenvoorden, H.J., Jongeneel, N., Routine morphine infusion in preterm newborns who received ventilatory support: A randomized controlled trial (2003) J Am Med Assoc, 290, pp. 2419-2427 Kleinbaum, D.G., (1996) Logistic Regression: A Self-learning Text, , New York: Springer Balda, R.C., (2001) Fatores que Interferem na Comunicação da dor Entre o Recém-nascido e o Adulto que Ïobserva: Influência das Características Pessoais e Profissionais do Observador, , [tese]. São Paulo (SP): Universidade Federal de São Paulo Castro, M.C., Guinsburg, R., Almeida, M.F., Peres, C.A., Yanaguibashi, G., Kopelman, B.I., Perfil da indicação de analgésicos opióides em recém-nascidos em ventilação pulmonar mecânica (2003) J Pediatr (Rio J), 79, pp. 41-48 Chermont, A.G., Guinsburg, R., Balda, R.C., Kopelman, B.I., O que os pediatras conhecem sobre avalia ção e tratamento da dor no recém-nascido? (2003) J Pediatr (Rio J), 79, pp. 265-272 Elias, L.S., (2003) Os Pais e os Profissionais de Saúde Concordam Quanto à Avaliação da Possível dor Sentida por Recém-nascidos Internados em Unidade de Terapia Intensiva?, , [dissertação]. São Paulo (SP): Universidade Federal de São Paulo Anand, K.J., Consensus statement for the prevention and management of pain in the newborn (2001) Arch Pediatr Adolesc Med, 155, pp. 173-180 Kahn, D.J., Richardson, D.K., Gray, J.E., Bednarek, F., Rubin, L.P., Shah, B., Variation among neonatal intensive care units in narcotic administration (1998) Arch Pediatr Adolesc Med, 152, pp. 844-851 Burokas, L., Factors affecting nurses' decisions to medicate pediatric patients after surgery (1985) Heart Lung, 14, pp. 373-379 Schechter, N.L., The undertreatment of pain in children (1989) Pediatr Clin North Am, 36, pp. 781-794 Hadjistavropouios, H.D., Craig, K.D., Grunau, R.E., Whitfield, M.F., Judging pain in infants: Behavioral, contextual and developmental determinants (1997) Pain, 73, pp. 319-324 Guinsburg, R., Peres, C.A., Almeida, M.F., Balda, R.C., Berenguel, R.C., Tonelotto, J., Differences in pain expression between male and female newborn infants (2000) Pain, 85, pp. 127-133 Chambers, C.T., Giesbrecht, K., Craig, K.D., Bennett, S.M., Hunstman, E., A comparison of faces scales for measurement of pediatric pain: Children's and parent's ratings (1999) Pain, 83, pp. 25-35 Anand, K.J.S., Selanikio, J.D., Routine analgesic practices in 109 neonatal intensive care units (1996) Pediatr Res, 39, pp. 192A Stevens, B., McGrath, P., Gibbins, S., Beyene, J., Breau, L., Camfield, C., Procedural pain in newborns at risk for neurologic impairment (2003) Pain, 105, pp. 27-35 Shannon, M., Berde, C.B., Pharmacologic management of pain in children and adolescents (1989) Pediatr Clin North Am, 36, pp. 885-971 Zempsky, T.W., Schechter, N.L., What's new in the management of pain in children (2003) Pediatr Rev, 24, pp. 337-348 Porter, F.L., Anand, K.J., Epidemiology of pain in neonates (1998) Res Clin Forums, 20, pp. 9-17 Bauchner, H., May, A., Coates, E., Use of analgesic agents for invasive medical procedures in pediatric and neonatal intensive care units (1992) J Pediatr, 121, pp. 647-649 Porter, F., Miller, J.P., Marshall, R.E., Local anesthesia for painful medical procedures in sick newborns (1987) Pediatr Res, 21, pp. 374A Guinsburg, R., Kopelman, B.I., Anand, K.J., Almeida, M.F., Peres, C.A., Miyoshi, M.H., Physiological, hormonal and behavioral response to a single fentanyl dose in intubated and ventilated preterm neonates (1998) J Pediatr, 132, pp. 954-959 Anand, K.J., Barton, B.A., McIntosh, N., Lagercrantz, H., Pelausa, E., Young, T.E., Analgesia and sedation in preterm neonates who require ventilatory support (1999) Arch Pediatr Adolesc Med, 153, pp. 331-338 Anand, K.J., Hall, R.W., Desai, N., Shephard, B., Bergqvist, L.L., Young, T.E., Effects of morphine analgesia in ventilated preterm neonates: Primary outcomes from the NEOPAIN randomized trial (2004) Lancet, 363, pp. 1673-1682 Anand, K.J., Brown, M.J., Bloom, S.R., Aynsley-Green, A., Studies on the hormonal regulation of fuel metabolism in the human newborn infant undergoing anaesthesia and surgery (1985) Horm Res, 22, pp. 115-128