Pregledni rad
CURTAILING PROCEDURAL PAIN / STRESS IMPACT IN EXTREMELY PREMATURE INFANTS: CURRENT PRUDENCE AND CROATIAN CONSUETUDE
ANA ČOLIĆ
; Zavod za neonatologiju, Klinika za ženske bolesti i porode, Klinički bolnički centar Zagreb, Hrvatska
NENAD VUKOJEVIĆ
; Medicinski fakultet, Sveučilište u Zagrebu, Klinika za očne bolesti, Klinički bolnički centar Zagreb, Hrvatska
SONJA ANIĆ JURICA
; Zavod za neonatologiju, Klinika za ženske bolesti i porode, Klinički bolnički centar Zagreb, Hrvatska
Sažetak
For a long time belief persisted that premature infants do not experience pain. Extremely premature newborns are exposed to number of diagnostic and therapeutic interventions during their stay in neonatal intensive care units. That time coincides the time of rapid brain development, when transitional neuronal structures are particularly vulnerable. Repeated painful and stressful procedures have proven impact on brain development of premature infant. As long-term effects of procedural pain and stress were recognized efforts of reduction became an imperative of neonatal medicine. We present non-pharmacological and pharmacological methods of procedural pain control; action, known side-effects and effi cacy. We also refer to practice of high level neonatal intensive care units in Croatia. Non-pharmacological methods such as non-nutritive sucking, facilitated tucking, swadling, parental involvement, and others, have proven effi ciency in pain control of many procedures causing mild pain. In combination with topical anesthetics and sweeteners they are effective in procedures of moderate intensity. Non-farmacologicala methods affect transmission of painful stimuli and as sweeteners dampen behavioral response. Among drugs opioids are far most effective during severly painful procedures and side-effects should be balanced with impact of pain and stress. Eye examination for retinopathy of prematurity is an inevitable procedure stressful at the very eye drops application. It demands to be marked since only opioids have proven absolute effi cacy which should be kept in mind with ventilated and haemodynamically unstable patients. Non-pharmacological methods as well as topical anestetics are uneffective when heel lance for blood sampling is performed. Overall, awareness of pain and stress in Croatian high level units exists, but recognition of pain and stress malevolence and action in terms of prevention are still insuffi cient, especially in terms of mild to moderate intensity procedures.
Ključne riječi
premature infant; newborn infant; pain; pain management; analgesia; retinopathy of prematurity
Hrčak ID:
294451
URI
Datum izdavanja:
27.2.2023.
Posjeta: 368 *