Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
권호 표지
DOI QR코드

DOI QR Code

Pain Response to Procedural Pain in Premature Infants

미숙아의 시술 관련 통증 반응

  • Kim, Jung-Sook (Neonatal Intensive Care Unit, Samsung Medical Center) ;
  • Lee, Eun-Jung (Neonatal Intensive Care Unit, Samsung Medical Center) ;
  • Ham, Eun-Ha (Neonatal Intensive Care Unit, Samsung Medical Center) ;
  • Kim, Ji-Hyun (Neonatal Intensive Care Unit, Samsung Medical Center) ;
  • Yi, Young-Hee (Graduate School of Clinical Nursing Science, Sungkyungkwan University)
  • 김정숙 (삼성서울병원 신생아중환자실) ;
  • 이은정 (삼성서울병원 신생아중환자실) ;
  • 함은하 (삼성서울병원 신생아중환자실) ;
  • 김지현 (삼성서울병원 신생아중환자실) ;
  • 이영희 (성균관대학교 임상간호대학원)
  • Received : 2010.09.20
  • Accepted : 2010.10.20
  • Published : 2010.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To explore premature infants' pain response to routine procedures in the neonatal intensive care unit (NICU). Methods: The participants were 56 preterm infants who showed 149 pain responses to 8 high frequency routine procedures which were evaluated using the Premature Infant Pain Scale (PIPS). Videotaped recording was used for data collection. Data were analyzed with descriptive analysis, paired t-test, and Pearson's correlation coefficient. Results: PIPS scores for each procedure were as follows; for removal of central catheter dressing, 6.17 (2.04), venous sampling, 6.12 (2.87), intramuscular injection, 6.05 (2.38), insertion of a peripheral line, 5.38 (2.16), insertion of feeding tube, 4.40 (1.34), heel stick, 4.33 (1.23), insertion of central line, 4.00 (2.12), and endotracheal suctioning, 2.90 (1.25). PIPS score was negatively correlated with gestational age (r=-.218, p=.007) and birth weight (r=-.249, p=.002) among general characteristics of the infants. Conclusion: The majority of 8 routine procedures were found to be painful for premature infants in the NICU. Therefore, adequate pain management related to procedures should be provided to premature infant in the NICU.

Keywords

References

  1. Ahn, H. S. (2007). Pediatrics (9th ed.). Seoul: Daehan printing & publishing CO., Ltd.
  2. Ahn, H. Y., Jang, M. Y., & Hur, M. H. (2006). The effect of oral glucose on pain relief in newborns. Journal of Korean Academy of Nursing, 36, 992-1001.
  3. Ahn, Y. M., Kang, H. O., & Shin, E. J. (2005). Pain assessment using CRIES, FLACC and PIPP in high-risk infants. Journal of Korean Academy of Nursing, 35, 1401-1409.
  4. Anand, K. (2007). Pain assessment in preterm neonates. Pediatrics, 119, 605-607. https://doi.org/10.1542/peds.2006-2723
  5. Anand, K., & Scalzo, F. (2000). Can adverse neonatal experiences alter brain development and subsequent behavior. Biology of the Neonate, 77, 69-82. https://doi.org/10.1159/000014197
  6. Carbajal, R., Rousset, A., Danan, C., Coquery, S., Nolent, P., Ducrocq, S., et al., (2008). Epidemiology and treatment of painful procedures in neonates in intensive care units. The Journal of the American Medical Association, 300, 60-70. https://doi.org/10.1001/jama.300.1.60
  7. Cignacco, E., Hamers, J. P., Stoffel, L., van Lingen, R. A., Schutz, N., Miller, R., et al. (2008). Routine procedures in NICUs: factors influencing pain assessment and ranking by pain intensity. Swiss Medical Weekly, 138, 484-491.
  8. Evans, J. C. (2001). Physiology of acute pain in preterm infants. Newborn and Infant Nursing Reviews, 1(2), 75-84. https://doi.org/10.1053/nbin.2001.25302
  9. Evans, J. C., Vogelpohl, D. G., Bourguignon, C. M., & Morcott, C. S. (1997). Pain behaviors in LBW infants accompany some "nonpainful" caregiving procedures. Neonatal Network, 16(3), 33-40.
  10. Fitzgerald, M. (1995). Developmental biology of inflammatory pain. British Journal of Anesthesia, 75, 177-185. https://doi.org/10.1093/bja/75.2.177
  11. Gray, J. E., Richardson, D. K., McCormick, M. C., Workman- Daniels, K., Goldmann, D. A. (1992). Neonatal therapeutic intervention scoring system: a therapy-based severity-of-illness index. Pediatrics, 90, 561-567.
  12. Grunau, R. V., Whitfield, M. F., Petrie, L. H., & Fryer, E. L. (1994). Early pain experience, child and family factors, as precursors of somatization: a prospective study of extremely premature and full term children. Pain, 56, 353-359. https://doi.org/10.1016/0304-3959(94)90174-0
  13. Han, K. J. (1998). A study on the environment for low birth weight infants in neonatal intensive care unit in the United States. The Korean Journal of Child Health Nursing, 4, 159-176.
  14. Holsti, L., Grunau, R., Oberlander, T., & Whitfield, M. (2004). Specific newborn Individualized developmental care and assessment program movements are associated with acute pain in preterm infants in the neonatal intensive care unit. Pediatrics, 114, 65-72. https://doi.org/10.1542/peds.114.1.65
  15. Kenner, C., & McGrath, J. (2004). Developmental care of newborns & infants: A guide for health professionals. Philadelphia, PA: Mosby.
  16. Kim, M. S., Kim, M. J., Ham, E. H., & Kim, K. M. (2006). Development of a Premature Infant Pain Scale (PIPS). Korean Academy of Fundamentals of Nursing, 13, 510-519.
  17. Long, J. G., Philip, A. G., & Lucey, J. F. (1980). Excessive handling as a cause of hypoxemia. Pediatrics, 65, 203-207.
  18. Marceau, J. (2003). Pilot study of a pain assessment tool in the neonatal intensive care unit. Journal of Paediatrics and Child Health, 39, 598-601. https://doi.org/10.1046/j.1440-1754.2003.00215.x
  19. McGrath, P. A. (1987). An assessment of children's pain: a review of behavioral, physiological and scaling techniques. Pain, 31(2), 147-176. https://doi.org/10.1016/0304-3959(87)90033-9
  20. Mitchell, A., & Boss, B. J. (2002). Adverse effects of pain on the nervous systems of newborns and young children: a review of the literature. The Journal of Neuroscience Nursing, 34, 228-236. https://doi.org/10.1097/01376517-200210000-00002
  21. Mitchell, A., Brooks, S., & Roane, D. (2000). The premature infant and painful procedures. Pain Management Nursing, 1(2), 58-65. https://doi.org/10.1053/jpmn.2000.7781
  22. Park, E. S., Sung, K. S., Oh, W. O., Im, H. S., Kim, E. S., Kim, Y. A., et al. (2006). Pain relieving effect of yakson therapy for Infants. Journal of Korean Academy of Nursing, 36, 897-904.
  23. Pillai Riddell, R., & Craig, K. (2007). Judgments of infant pain: the impact of caregiver identify and infant age. Journal of Pediatric Psychology, 32, 501-511.
  24. Pollock, T. R., & Franklin, C. (2004). Use of evidence-based practice in the neonatal intensive care unit. Critical Care Nursing Clinics of North America, 16 , 243-248. https://doi.org/10.1016/j.ccell.2004.02.006
  25. Porter, F. L., Wolf, C. M., & Miller, J. P. (1999). Procedural pain in newborn infants: the influence of intensity and development. Pediatrics, 104(1), e13. https://doi.org/10.1542/peds.104.1.e13
  26. Richardson, D. K., McCormick, M. C., Gray, J. E., & Goldmann, D. A. (1994). CRIB and SNAP. Lancet, 344, 124-125. https://doi.org/10.1016/S0140-6736(94)91307-2
  27. Spence, K., Gillies, D., Harrison, D., Johnston, L., & Nagy, S. (2005). A reliable pain assessment tool for clinical assessment in the neonatal intensive care unit. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 34, 80-86. https://doi.org/10.1177/0884217504272810
  28. Stevens, B., Johnston, C., Petryshen, P., & Taddio, A. (1996). Premature Infant Pain Profile: development and initial validation. The Clinical Journal of Pain, 12, 13-22. https://doi.org/10.1097/00002508-199603000-00004
  29. van Dijk, M., Koot, H. M., Saad, H. H., Tibboel, D., & Passchier, J. (2002). Observational visual analog scale in pediatric pain assessment: useful tool or good riddance. The Clinical Journal of Pain, 18, 310-316. https://doi.org/10.1097/00002508-200209000-00006
  30. Walker, S. M. (2005). Management of procedural pain in NICUs remains problematic. Paediatric Anaesthesia, 15, 909-912. https://doi.org/10.1111/j.1460-9592.2005.01758.x

Cited by

  1. Perceptions on Pain Management among Korean Nurses in Neonatal Intensive Care Units vol.8, pp.4, 2010, https://doi.org/10.1016/j.anr.2014.05.008