Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life

Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life

Alternative title Perfil da resposta multidimensional à dor em recém-nascidos prematuros no primeiro, terceiro e sétimo dias de vida
Author Serpa, Ana Beatriz Mello Autor UNIFESP Google Scholar
Guinsburg, Ruth Autor UNIFESP Google Scholar
Balda, Rita de Cássia Xavier Autor UNIFESP Google Scholar
Dos Santos, Amelia Miyashiro Autor UNIFESP Google Scholar
Areco, Kelsy Catherina Nena Autor UNIFESP Google Scholar
Peres, Clovis de Araujo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract CONTEXT AND OBJECTIVE: It is challenge to assess and treat pain in premature infants. The objective of this study was to compare the multidimensional pain assessment of preterm neonates subjected to an acute pain stimulus at 24 hours, 72 hours and seven days of life. DESIGN AND SETTING: Prospective cohort study, at Universidade Federal de São Paulo (UNIFESP). METHODS: Eleven neonates with gestational age less than 37 weeks that needed venepuncture for blood collection were studied. The exclusion criteria were Apgar score < 7 at five minutes, presence of any central nervous system abnormality, and discharge or death before seven days of life. Venepuncture was performed in the dorsum of the hand, and the heart rate, oxygen saturation and pain scales [Neonatal Facial Coding System (NFCS), Neonatal Infant Pain Scale (NIPS), and Premature Infant Pain Profile (PIPP)] were assessed at 24 hours, 72 hours and 7 days of life. NFCS and NIPS were evaluated prior to procedure (Tpre), during venepuncture (T0), and two (T2) and five (T5) minutes after needle withdrawal. Heart rate, O2 saturation and PIPP were measured at Tpre and T0. Mean values were compared by repeated-measurement analysis of variance. RESULTS: The pain parameters did not differ at 24 hours, 72 hours and 7 days of life: heart rate (p = 0.22), oxygen saturation (p = 0.69), NFCS (p = 0.40), NIPS (p = 0.32) and PIPP (p = 0.56). CONCLUSION: Homogeneous pain scores were observed following venepuncture in premature infants during their first week of life.

CONTEXTO E OBJETIVO: É um desafio avaliar e tratar a dor do bebê prematuro. O objetivo deste estudo foi comparar, diante de um mesmo estímulo doloroso agudo, as respostas multidimensionais à dor obtidas ao longo da primeira semana de vida de prematuros. TIPO DE ESTUDO E LOCAL: Coorte prospectiva, na Universidade Federal de São Paulo (UNIFESP). MÉTODOS: Estudo de 11 neonatos com idade gestacional inferior a 37 semanas e necessidade de punção venosa para coleta de sangue, sendo excluídos aqueles com Apgar < 7 aos cinco minutos, alterações do sistema nervoso central e os que faleceram ou tiveram alta até sete dias de vida. A punção venosa foi feita no dorso da mão e avaliou-se a freqüência cardíaca, a saturação de oxigênio e as seguintes escalas de dor: NFCS (Neonatal Facial Coding System), NIPS (Neonatal Infant Pain Scale) e PIPP (Premature Infant Pain Profile) com 24, 72 horas e no sétimo dia de vida. A NFCS e a NIPS foram pontuadas antes da punção venosa (Tpré), durante (T0), dois (T2) e cinco (T5) minutos após. A freqüência cardíaca, a saturação de oxigênio e a PIPP foram analisadas em Tpré e T0. Compararam-se os valores médios das variáveis nos três momentos por análise de variância com medidas repetidas. RESULTADOS: Não houve diferenças no primeiro, terceiro e sétimo dias para freqüência cardíaca (p = 0,22), saturação de oxigênio (p = 0,69), NFCS (p = 0,40), NIPS (p = 0,32) e PIPP (p = 0,56). CONCLUSÃO: Houve homogeneidade da avaliação da dor causada por punção venosa em prematuros, ao longo da primeira semana de vida.
Keywords Newborn infant
Premature infant
Pain
Pain measurement
Pain threshold
Recém-nascido
Prematuro
Dor
Avaliação da dor
Limiar da dor
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Grant number CAPES: 1068-02
Date 2007-01-01
Published in SERPA, Ana Beatriz Mello et al . Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life. Sao Paulo Med. J., São Paulo , v. 125, n. 1, p. 29-33, jan. 2007
ISSN 1516-3180 (Sherpa/Romeo, impact factor)
Publisher Associação Paulista de Medicina - APM
Extent 29-33
Origin http://dx.doi.org/10.1590/S1516-31802007000100006
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000258429600006
SciELO ID S1516-31802007000100006 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3481

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