The Effect of Swaddling and Oropharyngeal Colostrum During Endotracheal Suctioning on Procedural Pain and Comfort in Premature Neonates: A Randomized Controlled Trial.
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引用次数: 0
Abstract
Background: Endotracheal suctioning (ES) is a painful procedure frequently performed in the neonatal intensive care unit. This procedure negatively affects the comfort level of premature neonates.
Purpose: To determine the effect of 2 nonpharmacologic methods, swaddling and the administration of oropharyngeal colostrum, on the pain and comfort levels of preterm neonates during ES.
Methods: This randomized controlled experimental study comprised 48 intubated premature neonates (swaddling group n = 16; oropharyngeal colostrum group n = 16; and control group n = 16) at 26 to 37 weeks of gestation. The neonates were swaddled with a white soft cotton cloth or administered 0.4 mL of oropharyngeal colostrum 2 minutes before ES, according to the group in which they were included. Two observers evaluated the pain levels (Premature Infant Pain Profile-Revize [PIPP-R]) and comfort (Newborn Comfort Behavior Scale [COMFORTneo]) of the infants by observing video recordings of before, during, and after the procedure.
Findings/results: A significantly lower mean PIPP-R score was found in the swaddling group during ES compared with the control group ( P = .002). The mean COMFORTneo scores of the swaddling and oropharyngeal colostrum groups during ES ( P < .01, P = .002) and the mean PIPP-R and COMFORTneo scores immediately after ES and 5, 10, and 15 minutes later were significantly lower than the control group ( P < .005).
Implications for practice and research: Swaddling was effective both during and after the procedure, while oropharyngeal colostrum was effective only after the procedure in reducing ES-related pain in premature neonates. Swaddling and oropharyngeal colostrum were effective in increasing comfort both during and after the procedure.
背景：气管内吸引术（ES）是新生儿重症监护室中经常进行的一项痛苦的操作。目的：确定襁褓和口咽初乳这两种非药物方法对早产新生儿在 ES 过程中的疼痛和舒适度的影响：这项随机对照实验研究包括 48 名妊娠 26 至 37 周的插管早产新生儿（襁褓组 n = 16；口咽初乳组 n = 16；对照组 n = 16）。根据新生儿所在的组别，新生儿在 ES 前 2 分钟用白色软棉布裹襁褓或服用 0.4 mL 口咽初乳。两名观察员通过观察手术前、手术中和手术后的视频记录，评估婴儿的疼痛程度（早产儿疼痛档案-修订版[PIPP-R]）和舒适度（新生儿舒适行为量表[COMFORTneo]）：与对照组相比，襁褓组婴儿在 ES 期间的 PIPP-R 平均得分明显较低（P = .002）。在 ES 过程中，襁褓组和口咽初乳组的 COMFORTneo 平均得分（P 对实践和研究的意义）均低于对照组（P = 0.002）：襁褓在手术过程中和手术后都有效，而口咽初乳仅在手术后才能有效减轻早产新生儿与 ES 相关的疼痛。襁褓和口咽初乳都能有效提高手术过程中和手术后的舒适度。
期刊介绍：
Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features.
Each issue offers Continuing Education (CE) articles in both print and online formats.
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