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| www.smw.ch |
| Cignacco E, Hamers JPH, van Lingen RA, Zimmermann LJI, Müller R, Gessler P, Nelle M. |
Swiss Med Wkly 2008;138(43–44):635–645
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| Original article Peer reviewed article |
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| Summary Background: In Switzerland approximately 8% of infants are born prematurely. Some of them undergo mechanical ventilation including endotracheal suctioning (ETS). ETS is one of the most frequently performed interventions and is linked to stress and pain, but its treatment is controversial. In Switzerland there is a lack of standardisation in pain relief for ETS. Aims: To test the hypothesis that an intermittent dose of morphine reduces pain during ETS and that subsequent multisensorial stimulation (MSS), as a non pharmacological comforting intervention, helps infants to recover from experienced pain. Method: A randomized placebo controlled trial in two tertiary neonatal intensive care units (NICU) with a sample of 30 mechanically ventilated preterm infants was conducted. Pain was measured by three pain assessment tools (Bernese Pain Scale for Neonates, Premature Infant Pain Profile and Visual Analogue Scale) Results: Morphine did not lead to any pain relief from ETS as measured by three pain scales. Nor did the comforting intervention of MSS show any effect. Repeated-measure analysis of variance for the within and between groups comparison showed no statistical significance. Conclusions: The administration of morphine for pain relief in ventilated preterm neonates during ETS remains questionable and the use of MSS as a comforting intervention after painful stimulus cannot be recommended. The validity testing of the instruments for this patient population should undergo a systematic validation trajectory. Future research should focus on options among non pharmacological interventions for relieving pain during ETS. |
Institute of Nursing Science, University of Basel, Switzerland University of Maastricht, Section Nursing Science, Maastricht, The Netherlands Isala Clinics, Princess Amalia Department of Paediatrics, Division of Neonatology, Zwolle, The Netherlands University of Maastricht, Neonatology, Department of Paediatrics, Maastricht, The Netherlands PH Bern, School of Teacher Education, University of Applied Sciences, Bern, Switzerland Klinik für Kinder und Jugendliche, Klinikum Konstanz, Germany Children’s Hospital, Division of Neonatology, University Hospital Berne, Switzerland |
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Copyright © 2008 EMH Swiss Medical Publishers Ltd. |
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