Avtor/Urednik		Neubauer, David; Rutar, Veronika; Javh-Dobernik, Tanja
Naslov		Prepoznavanje, obravnavanje in preprečevanje bolečine pri novorojenčku in dojenčku
Prevedeni naslov		Assessment, management and prevention of pain in neonates and infants
Tip		članek
Vir		Rehabilitacija
Vol. in št.		Letnik 5, št. 1-2
Leto izdaje		2006
Obseg		str. 135-40
Jezik		slo
Abstrakt		Pain assesssment and evaluation in neonates and infants remains a difficttlt issue, while its management and prevention are much below optimal. Also medical educational programs do not include the topics of pain in their curricula and should pay much more attention to teach the evaluation of pain all medical students. There is also significant lack of evidence-based data which would enable us to use the whole panorama of pharmacological as well as non-pharmacological products in children during early developmental age. The authors present their own study on applicability of Neonatal Infant Pain Score (NIPS) as well as the evaluation of effective and safe interventions that relieve pain in neonates and infants. The hypotheses were: NIPS is applicable in clinical practice, oral glucose solution and application of topical anaesthetic (EMLA) are effective. Results of the study confirmed ease and reliabilty of the NIPS scoring system for good and objective assessment of pain during the early age; there were some beneficial effects of glucose solution regarding the decrement of pain immediately after the procedure, however the results were not statistically significant when compared to no intervention. The effect of EMLA cream, however was not proven. The authors conclude that more evidence-based research is needed in this field to improve our knowledge as well as our routine daily practices regarding the managmement of pain during this early developmental age.
Izvleček		Prepoznavanje in vrednotenje bolečine pri novorojenčkih in dojenčkih je zapleteno, vendar danes obstajajo številne lestvice, ki omogočajo dovolj zanesljiva in objektivna tolmačenja vrste, oblike in stopnje bolečine glede na starost. Prav tako se v današnjem izobraževalnem zdravstvenem sistemu in v zdravstvenem varstvu nasploh še niso uveljavila načela dobre klinične prakse in z dokazi podprte medicine, ki bi zastopala mnenja, da so potrebni tako farmakološki kot nefarmakološki ukrepi za preprečevanje in zdravljenje bolečine v zgodnjem razvojnem obdobju. Avtorji v pričujočem delu navajajo svoje lastne rezultate raziskave o uporabi enostavnega merila za ocenjevanje bolečine pri novorojenčkih in dojenčkih - lestvice NIPS (neonatal infant pain scale). Prikažejo objektivnost, zanesljivost in veljavnost te lestvice kot zelo enostavnega orodja za opredlitev bolečine v zgodnjem razvojnem obdobju. Poleg tega so avtorji poskusili uporabiti tudi enostavne ukrepe za preprečevanje bolečine, in sicer z uporabo oralne raztopine glukoze (2 ml 30% raztopine glukoze) in z uporabo loklanega anestetičnega sredstva (krema EMLA) na mestu posega na koži. Rezultati so pokazali, da je lestvica NIPS zelo uporabna za ocenjevanje bolečine pri novorojenčkih in dojenčkih, saj je pokazala statistično značilno objekivnost in zanesljivost. Vpliv glukoze na zmanjševanje občutka bolečine v tem obdobju in pri posegu venepunkcije je sicer ugoden, vendar ne statistično značilen, medtem ko se v pričujoči raziskavi krema EMLA ni izkazala, kot dovolj uspešna za preprečevanje bolečine. Avtroji zato menijo, da v prihodnje potrebujemo še več študij, ki bi s postopki z dokazi-podprte medicine prinesle rezultate, s katerimi bi lahko v vsakdanji klinični praksi pripomogli k obravnavi in preprečevanju bolečine v najzgodnejšem razvojnem obdobju.
Deskriptorji		PAIN PAIN MEASUREMENT GLUCOSE ANESTHETICS, LOCAL INFANT, NEWBORN INFANT