Tímarit hjúkrunarfræðinga - 01.12.2003, Side 29
FRÆÐIGREIN
Sykurlausn í munn við verkjum
hjá fyrirburum og...
verkjameðferðin skipti máli. Það að lina sárs-
auka hjá fyrirburum og veikum fullburða börn-
um er brýnt verkefni sem komið getur í veg fyrir
varanlegan skaða hjá þeim börnum sem í hlut
eiga (Porter og Anand, 1998). Auk þess snýst
slík verkjameðferð um mannúð og virðingu fyrir
þessum litlu skjólstæðingum okkar og rétti
þeirra til sem minnstrar vanlíðanar og mestrar
mögulegrar vellíðanar.
Af niðurstöðum þeim, sem áður eru nefndar, má
sjá að til boða standa nýir möguleikar við verkja-
meðferð nýbura sem verða fyrir smávægilegum
inngripum eins og blóðtöku með hælstungu, nál-
aruppsetningu, mænuholsástungu, þvagástungu,
brjóstholsástungu, uppsetningu barkarennu og
fleira. Frekari rannsókna er þörf til að staðfesta
gagnsemi sykurlausnar í munn við að lina sárs-
auka við margvíslegar aðstæður og meðal undir-
hópa nýbura. Auk þess þarf að stilla útfærslur af
eftir þörfum, s.s. styrk lausnarinnar sem gefa á.
Aðferðin lofar þó almennt góðu við meðferð
verkja hjá nýburum, bæði hvað áhættu og árang-
ur varðar. Við hvetjum hjúkrunarfræðinga á
nýburagjörgæslu- og fæðingardeildum til að taka
þátt í því að nota og þróa frekar gjöf súrkrósa-
lausnar við verkjum hjá skjólstæðingum sínum
en jafnframt fylgjast náið með þróun þekkingar á
þessu sviði á komandi árum.
Heimildaskrá
Abad, F., Diaz, N.M., Robayna, M., og Rico, J. (1996). Oral sweet
solution reduces pain-related behaviour in preterm infants. Acta
Pœdiatrica, 85, 854-858.
Allen, K.D., White, D.D., og Walburn, J.N. (1996). Sucrose as an anal-
gesic agent for infants during immunization injections. Archives
of Pediatric and Adolescent Medicine, 150, 270-274.
Anand, KJ.S., og Carr, D.B. (1989). The neuroanatomy, neurophysi-
ology, and neurochemistry of pain, stress, and analgesia in new-
borns and children. Pediatric Clinics of North America, 36, 795-
822.
Anand, K.J.S., og McGrath, P.J. (ritstj.). (1993) Pain in neonates.
Elsevier.London, Bretlandi.
Anand, KJ.S,. og Craig, K.D. (1996). New perspectives on the defini-
tion of pain. Pain, 67, 3-6.
Barker, D.P., og Rutter, N. (1995). Expousure to invasive procedures in
neonatal intensive care unit admissions. Archives ofDisease in
Childhood Fetal Ct Neonatal Edition, 72, F47-F48.
Blass, E., og Ciaramitaro, V.A. (1994). A new look at some old
mechanisms in human newborns: Taste and tactile determinants
of state, affect and action. Monographies ofSocial Research in
Child Development, 59, 1-80.
Blass, E., og Hoffmeyer, L.B. (1991). Sucrose as an analgesic for new-
born infants. Pediatrics, 87(2), 215-218.
Blass, E.L., og Watt, LB. (1999). Suckling- and sucrose-induced anal-
gesia in human newborns, Pain, 83, 611-623.
Bucher, H.U., Moser, T., Von Siebenthal, K., Keel, M., Wolf, M., og Duc,
G. (1995). Sucrose reduces pain reaction to heel lancing in pre-
term infants: A placebo-controlled, randomized and masked
study. Pediatric Research, 38(3), 332-335.
Carbajal, R., Chauvert, S., og Oliver-Martin, M. (1999). Randomised trial of analgesic
effects of sucrose, glucose, and pacifiers in term neonates. The British MedicalJo-
urnal, 319, 1393-1397.
Cunningham, N. (1990). Ethical perspectives on the perception and treatment of neona-
tal pain. Journal of Perinatal and Neonatal Nursing, 4(1), 75-83.
Fitzgerald, M. (1995). Developmental biology of inflammatory pain. British Journal of
Anaesthesia, 75, 177-185.
Franck, LS., Greenberg, C.S., og Stevens, B. (2000). Pain Assessment in Infants and
Children. Pediatric Clinics of North America, 47(3), 487-512.
Gibbins, S., Stevens, B., Hodnett, E„ Pinelli, J„ Ohlsson, A„ og Darlington, G. (2002).
Efficacy of sucrose for procedural pain in preterm and term neonates. Nursing Re-
search, 57(6), 375-382.
Ginnakoulopoulos, X„ Sepulveda, W„ Ploutarchos, K„ o.fl. (1994). Fetal plasma cortisol
and beta-endorphin response to intrauterine needling. Lancet, 344,77-81.
Grunau, R.V.E., Whitfield, M„ Petrie, J„ o.fl. (1994a). Early pain experience, child and
family factors, as precursors of somatization: A prospective study of extremely pre-
mature and full-term children. Pain, 56, 353-359.
Grunau, R.V.E., Whitfield, M„ Petrie, J„ o.fl. (1994b). Pain sensitivity and temperament in
extremely low-birth-weight premature toddlers and preterm and full-term controls.
Pain, 58, 341-346.
Grunau, R.V.E. (1998). Long-term effects of pain. Research and Clinical Forums, 20(4),19-
28.
Haouari, N„ Wood, C„ Griffiths, G„ og Levene, M. (1995). The analgesic effect of sucrose
in full term infants: A randomised controlled trial. The British Medical Journal,
370(6993), 1498-1500.
Johnston, C.C., Stevens, B.J., Yang, F„ og Horton, L. (1995). Differential response to pain
by very premature neonates. Pain, 61, 471- 479.
Johnston, C.C., og Stevens, BJ. (1996). Experience in the neonatal intensive care unit af-
fects pain response. Pediatrics, 98(5), 925- 930.
Jorgensen, K. (1999). Pain assessment and management in the newborn infant. Journal
of PeriAnesthesia Nursing, 74(6), 349-356.
McGrath, P.A. (1990). Pain in children: Nature, assessment, and treatment. The Guilford
Press, New York, 41 -59.
Moore, K.L, og Persaud, T.V.N. (1993). The Developing Human. W.B. Saunders Company,
Philadelphia.
Porter, F.L., og Anand, KJ.S. (1998). Epidemiology of pain in neonates. Research and Clin-
ical Forums, 20(4), 9-16.
Ramenghi, L„ Wood, C„ Griffith, G„ og Levene, M. (1996a). Reduction of pain response in
premature infants using intraoral sucrose. Archives ofDisease in Childhood Fetal Et
Neonatal Edition, 74(2), 126F-128F.
Ramenghi, L„ Griffith, G„ Wood, C„ og Levene, M. (1996b). Effect of non-sucrose sweet
tasting solution on neonatal heel prick responses. Archives of Disease in Childhood
Fetal Et Neonatal Edition, 74(2), 129F-131F.
Ramenghi, L„ Evans, D„ og Levene, M. (1999). "Sucrose analgesia": Absoptive mechanism
or taste perception? Archives ofDisease in Childhood Fetal Et Neonatal Edition, 80(2),
146F-147F.
Rushforth, J.A., og Levene, M. (1993). Effect of sucrose on crying in response to heel
stab. Archives ofDisease in Childhood, 69, 388-389.
Shapiro, C. (1989). Pain in the neonate: Assessment and intervention. Neonatal Network,
8(1), 7-21.
Skogsdal, Y„ Eriksson, M„ og Schollin, J. (1997). Analgesia in newborns given oral
glucose. Acta Pœdiatrica, 86, 217-220.
Stevens, B„ Taddio, A„ Ohlsson, A„ og Einarson, T. (1997). The efficacy of sucrose for re-
lieving procedural pain in neonates: A systemic review and meta-analysis. Acta
Pœdiatrica, 86, 837-842.
Stevens, B„ Johnston, C„ Franck, L, Petrysen, P„ Jack, A„ og Foster, G. (1999). The
efficacy of developmentally sensitive interventions and sucrose for relieving
procedural pain in very low birth weight neonates. Nursing Research, 48(1), 35-43.
Stevens, B„ Yamada, J„ og Ohlsson, A. (2002). Sucrose foranalgesia in newborn infants
undergoing painful procedures. The Cochrane Database of Systematic Reviewes,
Volume (Issue 1). Sótt 21. feb. 2002, á http://gateway2.ovid.com/ovidweb.cgi
Taddio, A„ Goldbach, M„ Ipp, M„ o.fl. (1995). Effect of neonatal circumcision on pain
responses during vaccination in boys. Lancet, 345, 291.
Taddio, A„ Katz, J„ llersich, A.L, o.fl. (1997). Effect of neonatal circumcision on pain
responses during subsequent routine vaccination. Lancet, 349, 599
Vander, A.J., Sherman, J.H., og Luciano, D.S. (1990). Human Physiology[5. útgáfa).
McGraw-Hill Publishing Company, New York.
Wolf, A.R. (1999). Pain, nociception and the developing infant. Pediatric Anaesthesia, 9,
7-17.
Timarit islenskra hjúkrunarfræöinga 5. tbl. 79. árg. 2003 ; 2'