Author/Editor		Javh, Tanja; Rutar, Veronika
Title		Prepoznava, obravnava in preprečevanje bolečine pri novorojenčkih in dojenčkih
Translated title		Assessment, management and prevention of pain in neonates and infants
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 42, št. 2
Publication year		2003
Volume		str. 119-31
Language		slo
Abstract		Pain assessment and evaluation in neonates and infants remains a significant problem. Pain management and prevention in this age group is less than optimal. Nonpharmacologic and pharmacologic interventions for relief of pain during minor invasive procedures are infrequently employed. Recent research evidence has shown the efficacy of sugar solutions and topical anaesthetics for relief of procedural pain. The employement of neonatal pain assessment tools that are easily aplicable in clinical settings would provide more objective evaluation of pain response, the development of pain management care plans, and the effectiveness of pain relief interventions. The objectives of this study were to assess the applicability of Neonatal Infant Pain Scale (NIPS) in clinical settings and evaluate effective and safe interventions that relieve pain in neonates and infants. Hypotheses:1. NIPS is applicable in the clinical settings. 2. Oral glucose solution is effective in reducing pain-related behavior in neonates and infants undergoing minor invasive procedures. 3. Application of a topical anaesthetic is effective in reducing pain-related behavior in neonates and infants undergoing minor invasive procedure. 60 neonates and infants undergoing venepuncture and intravenous catheter insertion randomly assigned to one of three treatment groups: (1) no treatment, (2) oral glucose solution, (3) topical anaesthetic. Statistical analysis: internal consistency of NIPS was established by Cronbach's alphas; interrater reliability of NIPS was established by Pearson's correlations, concurrent validity was established by correlations with heart rate. Differences between group median pain scores were established by analyses of variance. Internal consistency was high: Cronbach's alphas ranged from 0,87 to 0,91. Interrater reliability was high: Pearson's correlations ranged from 0,86 to 0,94. (Abstract truncated at 2000 characters).
Summary		Prepoznava in vrednotenje bolečine pri novorojenčkih in dojenčkih sta težavna. Obravnava in preprečevanje bolečine pri tej starostni skupini nista optimalna. Nefarmakološki in farmakološki ukrepi za preprečevanje bolečine pri manjših invazivnih posegih se redko uporabljajo. Dosedanje raziskave kažejo na učinkovitost raztopin sladkorjev in lokalnih anestetikov pri zmanjšanju odziva na bolečino ob posegih. V klinični praksi bi uvedba uporabnega in enostavnega merila za ocenjevanje bolečine omogočila objektivnejšo oceno stopnje bolečine in olajšala načrtovanje ukrepov za preprečevanje bolečine ter oceno učinkovitosti teh ukrepov. Naš namen je bil oceniti uporabnost in veljavnost lestvice za ocenjevanje bolečine pri novorojenčkih in dojenčkih (NIPS). Želeli smo oceniti tudi možnosti preprečevanja bolečine ob manjših invazivnih posegih pri novorojenčkih in dojenčkih in objektivno oceniti tovrstne ukrepe preprečevanja. Hipoteze: 1. Lestvica NIPS je uporabna pri ocenjevanju bolečine pri novorojenčkih in dojenčkih. 2. Uporaba oralno dane raztopine glukoze pri novorojenčkih in dojenčkih zmanjša odziv na bolečino ob odvzemu venske krvi ali nastavitvi znotrajvenske poti. 3. Uporaba lokalnega anestetika na mestu posega pri novorojenčkih in dojenčkih zmanjša odziv na bolečino ob odvzemu venske krvi ali nastavitvi znotrajvenske poti. V raziskavo smo vključili 60 naključno izbranih novorojenčkov in dojenčkov, ki so potrebovali odvzem venske krvi oz. nastavitev znotrajvenske poti. Ocenjevali smo odziv na bolečino in učinkovitost ukrepov za preprečevanje bolečine. Glede na ukrepe preprečevanja bolečine smo novorojenčke oz. dojenčke razdelili na tri skupine: 1. brez ukrepov, 2. glukozna raztopina, 3. lokalni anestetik. Uporabnost lestvice smo preverjali s Cronbachovim koeficientom a (a) in s Pearsonovim korelacijskim koeficientom (r). (Izvleček skrajšan na 2000 znakov).
Descriptors		PAIN PAIN MEASUREMENT GLUCOSE ANESTHETICS, LOCAL INFANT, NEWBORN INFANT