RESUMO
INTRODUCTION: Young children perceive pain as much, or even more than adults, and the pain may have short- and long-term consequences. The literature describes the use of non-pharmacological interventions to alleviate pain during vaccination. The aim of this study was to assess 3such interventions for analgesia during vaccination: non-nutritive sucking (NNS), breastfeeding (BF), and administration of a 50% dextrose solution (D50W). MATERIALS AND METHODS: A prospective, non-randomised cohort study was carried out on infants aged 2, 4 and 6 months that received 1, 2, or 3 vaccines, respectively, according to the routine immunisation schedule. There were 3treatments: NNS, BF, and 2mL of D50W combined with NNS. Pain was assessed using the LLANTO scale, and the duration of crying. RESULTS: The study included 387 infants. The mean scores in the LLANTO scale at ages 2 and 6 months were significantly lower in breastfed infants compared to infants managed with NNS (P=.025 and P<.001, respectively), or infants given D50W (P=.025 and P=.001), and the difference was not statistically significant at age 4 months (P=.21 and P=.27). There were no significant differences between infants managed with NNS and D50W at 2, 4, and 6 months (P=.66, P=.93 and P=.45, respectively). The duration of crying was significantly lower at age 6 months in breastfeed infants compared to infants managed with NNS or D50W (P=.013 and P=.017). No breastfed child (n=129) experienced side effects. CONCLUSIONS: In infants born to term with adequate weight for gestational age, breastfeeding reduces pain on the administration of 1 or 2 vaccines. When 3 vaccines are given, the reduction is minimal. Administration of D50W does not have any additional analgesic effect in infants compared to being held by a parent combined with NNS during vaccination. BF during vaccination is not associated with any side effects.
Assuntos
Aleitamento Materno/métodos , Manejo da Dor/métodos , Dor/etiologia , Vacinação/efeitos adversos , Fatores Etários , Estudos de Coortes , Choro , Feminino , Glucose/administração & dosagem , Humanos , Lactente , Masculino , Medição da Dor , Estudos Prospectivos , Comportamento de Sucção , Vacinação/métodos , Vacinas/administração & dosagem , Vacinas/efeitos adversosRESUMO
Estudo experimental com abordagem quantitativa, cujo objetivo foi demonstrar que a sucção não nutritiva é efetiva no manejo da dor durante a instalação, pela equipe de enfermagem, do CPAP nasal em recém-nascidos prematuros; e demonstrar que o uso da sucção não nutritiva, concomitantemente à instalação do CPAP nasal, pode ser considerado uma tecnologia de enfermagem. A população alvo foi constituída por 20 recém-nascidos prematuros, submetidos à instalação ou reinstalação do referido artefato, totalizando 30 procedimentos. Os recém-nascidos foram distribuídos, aleatoriamente, em dois grupos, controle e experimental, em que a sucção não nutritiva foi oferecida, o mesmo não acontecendo com o grupo controle. As reações de dor foram mensuradas pela escala de NIPS. Em 100% dos procedimentos concomitantes à sucção não nutritiva, os recém-nascidos não sentiram dor; 100% dos recém-nascidos demonstraram dor quando não era oferecida a referida sucção. Conclui-se que o procedimento pode ser classificado como uma tecnologia do cuidado de enfermagem.
This is an experimental study with a quantitative approach, whose goal was to demonstrate that non-nutritive sucking is effective in pain management during installation, by the nursing staff, of nasal CPAP in preterm infants; and to demonstrate that the use of non-nutritive sucking, concomitantly with the installation of nasal CPAP can be considered a nursing technology. The target population consisted of 20 preterm infants undergoing installation or reinstallation of this artifact, totaling 30 procedures. The newborns were divided randomly into two groups, control and experimental, in which non-nutritive sucking was offered, the same do not happening with the control group. The reactions of pain were measured by the scale of NIPS. In 100% of the procedures that occurred concomitant with non-nutritive sucking, newborns did not feel pain; and 100% of the newborns showed pain when such suction was not offered. We conclude that the procedure can be classified as a technology of nursing care.
Estudio experimental con un enfoque cuantitativo, cuyo objetivo fue demostrar que la succión no nutritiva es eficaz en el tratamiento del dolor durante la instalación, por personal de enfermería, de la CPAP nasal en bebés prematuros; y demostrar que el uso de la succión no nutritiva, concomitantemente a la instalación de la CPAP nasal, puede ser considerada una tecnología de enfermería. La población-objetivo consistió en 20 recién nacidos prematuros sometidos a la instalación o reinstalación de este artefacto, en un total de 30 procedimientos. Los recién nacidos fueron divididos aleatoriamente en dos grupos, control y experimental, en el que se ofrece la succión no nutritiva, lo mismo no ocurriendo con el grupo control. Las reacciones de dolor se midieron por la escala de NIPS. En 100 % de los procedimientos concomitantes con succión no nutritiva, los recién nacidos no sentirán dolor; y 100 % de los recién nacidos mostró dolor cuando no se le ofreció la succión. Llegamos a la conclusión de que este procedimiento puede ser clasificado como una tecnología de cuidado de enfermería.
Assuntos
Humanos , Recém-Nascido , Recém-Nascido Prematuro , Enfermagem Neonatal , Manejo da Dor , Comportamento de Sucção , Enfermagem Neonatal/métodosRESUMO
Se realizó una revisión bibliográfica para conocer la eficacia de la succión no nutritiva en recién nacidos pretérmino como parte del programa diario de atención, con el fin de mejorar la calidad de vida, favoreciendo la recuperación del neonato hospitalizado y evitando posibles alteraciones motoras, cognitivas y sociales en las futuras etapas del desarrollo. De igual modo, se trató de establecer y definir la intervención del personal médico, así como informar y educar a los padres sobre la utilidad del uso de succión no nutritiva. Se realizó una búsqueda en las bases de datos MEDLINE y EMBASE que incluyera aquellos artículos publicados en los últimos seis años. Basado en la evidencia disponible, la succión no nutritiva en recién nacidos prematuros tiene beneficios clínicos, ya que disminuye de manera significativa la estancia hospitalaria y permite una transición más rápida de sonda orogástrica a alimentación por succión, así como un mejor rendimiento, sin efectos negativos a corto plazo.
A literature review was conducted to determine the effectiveness of non-nutritive sucking in preterm infants as part of daily care in order to improve the quality of life, thereby avoiding possible motor impairment, cognitive and social future stages of development and assisting in the speedy recovery of the hospitalized infant. Also establish and define the intervention of medical personnel and to inform and educate parents about the usefulness of using non-nutritive sucking. Search was conducted in MEDLINE and EMBASE, including those articles published in the last 6 years. Based on available evidence, non nutritive sucking preterm infants have clinical benefit (significantly reducing the duration of hospital stay in preterm infants and quick transition orogastric tube to bottle feeds and better performance bottle-feeding) and seem to have no negative effect in the short term.
