[Analgesia when taking heel-lance blood in the newborn]. / Analgesia en la toma sanguínea de talón en los recién nacidos.

OBJECTIVE: To evaluate the pain in healthy newborns requiring blood test by a heel-prick procedure and compare different pain management methods. PATIENTS AND METHOD: We studied 150 term infants, in three randomised groups, from the Maternity Unit of our Hospital for a period of three months. The first group of 50 newborns, received no specific analgesic intervention during blood tests, except our usual nursing intervention ("facilitated tucking"). The second and third group (50 newborns), received non-nutritive sucking-placebo and non-nutritive sucking-24% sucrose respectively. RESULTS: In the control group, the average score on the scale of discomfort was 3.92, moderate pain, causing a crying time of 51.72 seconds; the group receiving a non-nutritive sucking-placeboscored 2.1, slight pain, 10.68 seconds crying, while the group receiving non-nutritive sucking-24 % sucrose, expressed a level of discomfort of 1.5 points, slight, with an average crying time of 10.70 seconds. The comparative results between the control group and groups of non-nutritive sucking on placebo and 24% sucrose, both showed significant differences in the scores of the scale of discomfort, as well as in the time crying (p < 0.001). The comparative analysis between groups of non-nutritive sucking sucrose and placebo showed no significant differences. CONCLUSIONS: The blood test by heel lance represents a painful procedure of moderate intensity capable of analgesic treatment. A proper nursing method, along with a complement of non-nutritive sucking during extraction, significantly decreases the discomfort and crying, it being unnecessary to consider other analgesics.

[The clinical and epidemiological aspects of the neonatal abstinence syndrome]. / Aspectos clínicos y epidemiológicos del síndrome de abstinencia neonatal.

Retrospectively, were tested maternal-neonatal factors of 47 newborn with neonatal abstinence syndrome comparing them with a control group of 100 newborn, during the period from 1985 to 1991. An average incidence of 6/1000 living newborn were affected by abstinence syndrome. The mothers were young (75%), smokers (74%), unemployed (80%), with a high rate of previous abortions (21%) and with a bad pregnancy control. Within our environment, abstinence syndrome increase has been detected among children of young gypsy mothers. Heroin (88%) was the most popular drug. Nevertheless a change has been noted in the last few years in the drug administration going from intravenous to the inhalational route. The duration of syndrome was less in the newborn whose mothers had inhaled heroin and in the premature newborn. It was proved that there was a high rate of HIV (40%), hepatitis B (23%), and syphilis markers (25%).

[Diagnostic value of auditory brainstem evoked potentials (ABP) in high risk premature and newborn infants]. / Valor diagnóstico de los potenciales evocados auditivos troncoencefálicos (ABR) en prematuros y neonatos de alto riesgo.

In this work we have studied 37 children, both preterm and term, belonging ti high risk group of contracting hearing loss, in order to confirm the predictability of ABR in the diagnostic of the congenital hearing losses during the prenatal period and so make possible their immediate and proper rehabilitation. With this purpose we have studied parameters such as threshold, latency of waves and intervals. We have discovered that in preterm children, owing to reasons such as answers of little amplitude, movements of the children and difficulty to determine the gestational age, the parameters of normality are only the existence or not of waves, discarding the value of the threshold and the latency of waves. We have had to wait for 40 weeks to obtain ABR similar to the ones in adults, in which the threshold, latency of waves and intervals are certain to predict hearing. In spite of it all we have to agree that ABR are the best hearing test at those ages. We must not forget that normal ABR could include lesions in the upper part of hearing pathway.

[Influence of acoustic stimulation in the maturation of the auditory pathway]. / Influencia de la estimulación acústica en la maduración de la vía auditiva.

The aim of this study is to analyze the relationship between age and the maturational changes occurring in the peripherical auditory system and the influence of the acoustic stimulation. With this purpose Auditory Brainstem Responses (ABR) were recorded at the 35 and 39 weeks gestational age, in 56 ears of 28 premature infants. The ABR were analyzed the changes in latency values of the I, V waves and I-V intervals. In order to know the influence of the acoustic stimulation on the development of auditory pathway, we made 2 groups with the 28 premature children, one of them control group and the other stimulated with maternal voice from 35 till 39 weeks. The stimulated group had one maturate auditory evoked responses at 39 weeks gestational age. Showing a latency decrease wave V and I-V interval, compared to control group.

[Clinical and electrophysiological effects of auditive stimulation in preterm neonates]. / Efectos clínicos y electrofisiológicos de la estimulación auditiva en recién nacidos pretérmino.

Clinical results in 40 preterm newborns stimulated with maternal voice have been studied in a Neonatal Unit. We compared these results with a control group. After a period of ten days we observed a significant increase (p less than 0.001) in: weight gain (34 g. vs 26 g. per day), an advancement of the hospital discharge time of 3.8 days, spontaneous motor activity, hand sucking and increased interest in the human face. Auditory Brain Stem Response at 35 and 39 weeks, with a total of 21 registered in the experimental group vs 25 registered in the control group, showed that V wave latency decreased significantly (p less than 0.05) in the stimulated group--0.88 m.sc. vs, -0.61 m.sc.--in the control group. These results confirm an enhancement of the auditory way conduction speed from 0.06 m.sc. to 0.53 m.sc. (p less than 0.05).