Avaliação da percepção de dor em neonatos pré-termo sob sedo-analgesia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

This study aimed to: (1) assess the reactions of pain in preterm newborns who are under infusion of analgesic and sedative drugs during procedures for collecting blood sample and (2) test the validity of two behavioral instruments and two physiological indicators used for assessment pain in this population. For the validation of pain assessment tools, were filmed and analyzed 66 procedures for arterial and venous peripheral puncture performed in 28 neonates, among them 49 without sedoanalgesia and 17 neonates with sedoanalgesia. The assessment tools tested were the Neonatal Facial Coding System (NFCS), the Neonatal Infant Pain Scale (NIPS) and Visual Analogue Scale (VAS), as physiological measures were used the heart rate and oxygen saturation. The response Trunk Movement, introduced in the NFCS scale, showed good item-total correlation (r = 0.38). High internal consistency was found in both behavioural instruments: NFCS and NIPS (α ≥ 0.80) and strong correlations between these instruments (p <0.01) and with the scale VAS (p <0.01). In addition, the Factor Analysis showed high average load factor for the scales NFCS= 0.80 and NIPS = 0.74. Only the oxygen saturation showed significant differences according to the pharmacologic condition. For the reactions evaluations of infants under sedative and analgesic drugs to procedures of blood collection, were used only the first procedure of each registered ones of the 28 neonates. Thus, 28 pre-term babies were filmed during the performance of peripheral arterial and venous puncture procedures. These babies were divided into two groups: Group 1 (without sedo-analgesia, n = 21) and Group 2 (with sedoanalgesia, n = 7). It was used for these tests the tools validated in the first experiment of validation in this study. The results showed higher average levels of response in NFCS and NIPS to Group 1, however significant changes (p <0.05) between the periods T0, T1 and T2 were identified in both groups. Only the oxygen saturation showed significant changes in the procedure and only for the babies without sedoanalgesia. The arterial puncture was the type of procedure that showed higher scores on scales NIPS and NFCS and peripheral venous puncture was the one that demonstrated longer time duration. The results are discussed regarding the misuse of measures for the management of pain and the importance of assessing pain in the newborn hospitalized in the neonatal ICU.

ASSUNTO(S)

dor neonatologia ciencias da saude recém-nascidos prematuros

ACESSO AO ARTIGO

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