Percepción del personal de enfermería sobre el manejo del dolor en neonatos / Neonatal nurses' perceptions of pain management

Objetivos: Describir las percepciones del personal de enfermería de unidades neonatales sobre el manejo del dolor, conocer el perfil formativo y describir el uso de herramientas de valoración del dolor y de medidas no farmacológicas. Método: Estudio multicéntrico observacional descriptivo transversal desarrollado durante febrero-septiembre de 2015 en los Servicios de Neonatología de tres hospitales de la Comunidad de Madrid, España. La recogida de datos se realizó a través de cuestionario de elaboración propia enviado en formato papel o electrónico utilizando la plataforma Survey Monkey®. Resultados: La muestra consta de 142 profesionales (tasa de respuesta: 55%). El 47,9% (68) afirman que han recibido formación específica sobre el manejo del dolor. El 39,5% (56) refieren que el dolor se evalúa de forma habitual en su unidad. Tan solo el 43,6% refieren utilizar escalas validadas, siendo la PIPP la más usada. La contención y la succión no nutritiva son las medidas no farmacológicas más usadas, seguidas de la sacarosa. Se identifica la canalización intravenosa como el procedimiento más doloroso. Conclusiones: El manejo del dolor está en vías de mejora, ya sea por la formación como por la escasa evaluación a través de escalas validadas. Destaca la mejora en el uso de medidas no farmacológicas (AU)

Objectives: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. Methods: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. Results: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure.Conclusions: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy (AU)

Neonatal nurses' perceptions of pain management. / Percepción del personal de enfermería sobre el manejo del dolor en neonatos.

OBJECTIVES: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. METHODS: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. RESULTS: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure. CONCLUSIONS: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy.

Randomised crossover trial showed that using breast milk or sucrose provided the same analgesic effect in preterm infants of at least 28 weeks.

AIM: Repeated, ongoing exposure to pain influences the growth, cognitive and motor functions, behaviour, personality and neurodevelopment of preterm infants. We compared the analgesic effects of expressed breast milk (EBM) and 24% oral sucrose on preterm neonates during venipuncture. METHODS: This multicentre randomised, noninferiority, crossover trial focused on five neonatal university units in Madrid, Spain, from October 2013 to October 2014. It comprised 66 preterm infants born at less than 37 weeks and randomly split into two groups. They received either EBM or sucrose two minutes before venepuncture, together with nonnutritive sucking and swaddling, then the opposite procedure at a later point. Pain was measured with the premature infant pain profile (PIPP) and crying was also measured. RESULTS: There were no statistically significant differences between the groups. The PIPP scores were seven (4-9) with breast milk and six (4-8.25) with sucrose (p = 0.28). The 11 infants born at under 28 weeks of age showed higher median scores of nine (9-14) for breast milk and four (4-7) for sucrose (p = 0.009). CONCLUSION: EBM and 24% sucrose had the same analgesic effect during venipuncture in most of the preterm neonates, but sucrose worked better in extremely preterm infants.