Full text
| |
| Author(s): |
Claudia Maria Gaspardo
Total Authors: 1
|
| Document type: | Master's Dissertation |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2006-08-11 |
| Examining board members: |
Maria Beatriz Martins Linhares;
Salim Moysés Jorge;
Gimol Benzaquen Perosa
|
| Advisor: | Maria Beatriz Martins Linhares |
| Abstract | |
Pain is inherent to the intensive treatment procedures offered to preterm neonates in Neonatal Intensive Care Units. The early and repeated experiences of pain may have a long-term effects for the vulnerable neonates. The American Academy of Pediatrics and the Canadian Pediatric Society recommend using a sucrose solution for pain relief in NICU during invasive and painful procedures. The present study had the purpose to assess the pain reactions of preterm neonates during a procedure for blood collection, evaluating the moment of puncture as well as the effects of handling the neonates for antisepsis and for bandages, and evaluating the efficacy of the intervention with the sucrose solution at 25% for pain relief by administering a single dose of 0.5 ml/Kg. Thirty-three neonates were randomly assigned to two groups: Sucrose Group (n=17) and Water Group (n=16). The neonates were evaluated during two consecutive days. In the first assessment, the neonates from both groups did not receive the solution before the painful procedure. In the second assessment, the Sucrose Group received oral sucrose and the Water Group received sterile water, two minutes before the invasive painful procedure of puncture for blood collection. Each evaluation was divided into five phases: Baseline, Preparation for Puncture (antisepsis), Puncture, Recovery with Handling (bandage), and Recovery without Handling. The indicators of pain were evaluated by the facial activity, measured by the Neonatal Facial Coding System. The level of activation of the neonates was measured by their sleep-awake state and heart rate. The between and within-group data analysis revealed that, on the first day of evaluation, the neonates anticipated their reaction to the painful puncture stimulus, and showed a significant increase in the behavioral indicators of facial activity, sleep-awake state, and heart rate evaluated at the Preparation for Puncture. Both groups showed a high behavioral and physiological reactivity in the Puncture phase, in comparison to the Baseline. During recovery, the physiological indicator of heart rate continued high. In the second day of evaluation, the neonates who received 0.5 ml/Kg of the sucrose solution at 25% showed lower scores of facial activity, which indicates they experienced less pain in comparison to the neonates who received sterile water before, during, and after the procedure of puncture for blood collection. However, there were no significant differences in terms of the physiological indicator of heart rate. It is concluded that the dose of 0.5 ml/kg of sucrose solution at 25%, recommended for the administration in repeated doses, was efficient for pain relief, evaluated by means of the reduction of behavioral indicators. However, the physiological indicator remained high, which suggests there is a need for other comfort manegement associated to sucrose, with the aim to diminish the state of activation and irritability of the central nervous system. (AU) | |