新生儿术后疼痛评估工具的应用进展

doi:10.3761/j.issn.2096-7446.2022.04.018

摘要/Abstract

摘要： 有效的疼痛评估是疼痛管理的前提。因新生儿无法主诉疼痛,适用于术后疼痛评估的工具不足,评估工具不常使用或使用不当,新生儿术后疼痛评估面临挑战。该文综述了新生儿术后疼痛评估工具的选用依据,介绍并比较了8种适用于新生儿术后疼痛评估的工具,以期为准确评估新生儿术后疼痛提供参考。

关键词: 新生儿护理, 手术后照护, 疼痛, 评估工具, 综述文献专题

Abstract: Effective pain assessment is a prerequisite for pain management. As neonates are unable to express their pain,the assessment tools for postoperative pain of them are inadequate,and the use of these tools is rare or inappropriate,postoperative pain assessment in neonates is challenging. This article reviews the selection of postoperative pain assessment tools in neonates,introduces and compares eight tools which are suitable for neonatal postoperative pain assessment,to provide a reference for accurate neonatal postoperative pain assessment.

Key words: Neonatal Nursing, Postoperative Care, Pain, Assessment Tools, Review Literature as Topic

林思雅, 李漓, 任许艳. 新生儿术后疼痛评估工具的应用进展[J]. 中华急危重症护理杂志, 2022, 3(4): 376-380.

LIN Siya, LI Li, REN Xuyan. Advances in application of postoperative pain assessment tools in neonates[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(4): 376-380.

参考文献

[1] McPherson C,Miller SP,El-Dib M,et al. The influence of pain,agitation,and their management on the immature brain[J]. Pediatr Res,2020,88(2):168-175.
[2] Walker SM.Long-term effects of neonatal pain[J]. Semin Fetal Neonatal Med,2019,4(4):101005.
[3] 中国医师协会新生儿科医师分会,中国当代儿科杂志编辑委员会. 新生儿疼痛评估与镇痛管理专家共识(2020版)[J]. 中国当代儿科杂志,2020,22(9):923-930.
Neonatology Branch of Chinese Medical Association,Editorial Board of Chinese Journal of Contemporary Pediatrics. Expert consensus on neonatal pain assessment and analgesia management(2020 edition)[J]. Chin J Contemp Pediatr,2020,22(9):923-930.
[4] Maxwell LG,Fraga MV,Malavolta CP.Assessment of pain in the newborn:an update[J]. Clin Perinatol,2019,46(4):693-707.
[5] Olsson E,Ahl H,Bengtsson K,et al.The use and reporting of neonatal pain scales:a systematic review of randomized trials[J]. Pain,2021,162(2):353-360.
[6] 江苏省新生儿科医疗质量控制中心. 新生儿重症监护病房医护人员对新生儿疼痛评估和镇痛管理的认知现状调查[J]. 中国当代儿科杂志,2021,23(12):1271-1275.
Jiangsu Province Medical Quality Control Centre of Neonatal Department. An investigation on the cognition of neonatal pain assessment and analgesia management among medical staff in the neonatal intensive care unit[J]. Chin J Contemp Pediatr,2021,23(12):1271-1275
[7] Anand KJS,Eriksson M,Boyle EM,et al.Assessment of conti-nuous pain in newborns admitted to NICUs in 18 European countries[J]. Acta Paediatr,2017,106(8):1248-1259.
[8] Ilhan E,Galea C,Pacey V,et al.Trajectories of post-surgical pain in infants admitted to neonatal intensive care[J]. Eur J Pain,2020,24(9):1822-1830.
[9] Giordano V,Edobor J,Deindl P,et al.Pain and sedation scales for neonatal and pediatric patients in a preverbal stage of development:a systematic review[J]. JAMA Pediatr,2019,173(12):1186-1197.
[10] Krechel SW,Bildner J.CRIES:a new neonatal postoperative pain measurement score. Initial testing of validity and reliability[J]. Paediatr Anaesth,1995,5(1):53-61.
[11] Popowicz H,Kwiecień-Jagu K,Olszewska J,et al.Pain scales in neonates receiving mechanical ventilation in neonatal intensive care units-systematic review[J]. J Pain Res,2020,13:1883-1897.
[12] Hodgkinson K,Bear M,Thorn J,et al.Measuring pain in neonates:evaluating an instrument and developing a common language[J]. Aust J Adv Nurs,1994,12(1):17-22.
[13] Spence K,Gillies D,Harrison D,et al.A reliable pain assess-ment tool for clinical assessment in the neonatal intensive care unit[J]. J Obstet Gynecol Neonatal Nurs,2005,34(1):80-86.
[14] Hummel P,Puchalski M,Creech SD,et al.Clinical reliability and validity of the N-PASS:neonatal pain,agitation and sedation scale with prolonged pain[J]. J Perinatol,2008,28(1):55-60.
[15] Morgan ME,Kukora S,Nemshak M,et al.Neonatal Pain,Agitation,and Sedation Scale's use,reliability,and validity:a systematic review[J]. J Perinatol,2020,40(12):1753-1763.
[16] van Dijk M,Peters JW,van Deventer P,et al. The COMFORT Behavior Scale:a tool for assessing pain and sedation in infants[J]. Am J Nurs,2005,105(1):33-36.
[17] van Dijk M,Roofthooft DW,Anand KJ,et al. Taking up the challenge of measuring prolonged pain in(premature) neonates:the COMFORTneo scale seems promising[J]. Clin J Pain,2009,25(7):607-616.
[18] Stenkjaer RL,Pedersen PU,Hundrup YA,et al.Evaluation of NICU nurses' competence in pain assessment 5 years after implementation of the COMFORTneo scale[J]. Adv Neonatal Care,2019,19(5):409-415.
[19] 林紫,郑显兰,何瑞云,等. 兰氏新生儿疼痛评估量表用于机械通气新生儿急性疼痛评估的信效度分析[J]. 护理研究,2020,34(21):3801-3806.
Lin Z,Zheng XL,He RY,et al.Reliability and validity of LAN's Neonatal Pain Scale for acute pain assessment in neonates with mechanical ventilation[J]. Chin Nurs Res,2020,34(21):3801-3806.
[20] 何星蓉. 兰氏新生儿疼痛评估量表用于多种临床情境的调适、信效度检验及应用评价[D]. 重庆:重庆医科大学,2021.
He XR.Adjustment,reliability and validity test of the LAN's Neonatal Pain Assessment Scale in a variety of clinical set-tings and application evaluation of scale[D]. Chongqing:Chong-qing Medical University,2021.
[21] Lawrence J,Alcock D,McGrath P,et al. The development of a tool to assess neonatal pain[J]. Neonatal Netw,1993,12(6):59-66.
[22] Suraseranivongse S,Kaosaard R,Intakong P,et al.A compa-rison of postoperative pain scales in neonates[J]. Br J Anaesth,2006,97(4):540-544.
[23] 邵珍珍,朱琳,唐文娟,等. 儿童术后疼痛评估工具研究进展[J]. 护理学杂志,2021,36(5):102-108.
Shao ZZ,Zhu L,Tang WJ,et al.A review on postoperative pain assessment tools in children[J]. J Nurs Sci,2021,36(5):102-108.
[24] Stevens B,Johnston C,Petryshen P,et al.Premature Infant Pain Profile:development and initial validation[J]. Clin J Pain,1996,12(1):13-22.
[25] Stevens B J,Gibbins S,Yamada J,et al.The Premature Infant Pain Profile-Revised(PIPP-R):initial validation and feasibility[J]. Clin J Pain,2014,30(3):238-243.
[26] 何星蓉,郑显兰,柯淞淋,等. 基于3个英文版新生儿疼痛量表评估新生儿术后疼痛的信度和效度研究[J]. 中国循证儿科杂志,2021,16(3):186-191.
He XR,Zheng XL,Ke SL,et al.Reliability and validity of three English neonatal pain scales for postoperative pain assessment of newborns[J]. Chin J Evid Based Pediatr,2021, 16(3):186-191.
[27] Grunau RVE,Craig KD.Pain expression in neonates:facial action and cry[J]. Pain,1987,28(3):395-410.
[28] Peters JWB,Koot HM,Grunau RE,et al.Neonatal Facial Coding System for assessing postoperative pain in infants:item reduction is valid and feasible[J]. Clin J Pain,2003,19(6):353-363.
[29] Huang XZ,Li L,Zhou J,et al.Evaluation of three pain assess-ment scales used for ventilated neonates[J]. J Clin Nurs,2018, 27(19/20):3522-3529.
[30] Devsam BU,Kinney S.The clinical utility of the pain assess-ment tool in ventilated,sedated,and muscle-relaxed neonates[J]. Aust Crit Care,2021,34(4):333-339.
[31] Meesters NJ,van Dijk M,Knibbe CA,et al. Infants operated on for necrotizing enterocolitis:towards evidence-based pain gui-delines[J]. Neonatology,2016,110(3):190-197.
[32] Ten Barge JA,Vermeulen MJ,Simons SHP,et al. Pain mana-gement for necrotizing enterocolitis:getting the balance right[J]. Pediatr Res.2022,10.1038/s41390-022-01968-2.
[33] 贺芳,张喆,黄小知,等. 3种量表用于新生儿足跟采血疼痛评估的信效度分析[J]. 护理学报,2017,24(1):1-4.
He F,Zhang Z,Huang XZ,et al.Reliability and validity of three scales for assessment of heel lance pain in neonates[J]. J Nurs China,2017,24(1):1-4.
[34] Lim BG.Nociception monitoring tools using autonomic tone changes for intraoperative analgesic guidance in pediatric patients[J]. Anesth Pain Med(Seoul),2019,14(4):380-392.
[35] Kühlmann AYR,van Rosmalen J,Staals LM,et al. Music in-terventions in pediatric surgery(the music under surgery in children study):a randomized clinical trial[J]. Anesth Analg,2020,130(4):991-1001.
[36] 李梦婷,陈朔晖. 新生儿疼痛表情自动识别系统的研究进展[J]. 中华护理杂志,2019,54(11):1644-1647.
Li MT,Chen SH.Research progress on automatic recognition technology of neonatal pain expression[J]. Chin J Nurs,2019,54(11):1644-1647.