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Interventional Pain and Non-Pharmacologic Management among Neonates and Infants

Year 2018, , 169 - 178, 04.04.2018
https://doi.org/10.16948/zktipb.338176

Abstract

The pain is a problem that directly affects the health
status and leading to negative results in every domain of life when not
controlled. All of the children receive a series of painful interventions since
the moment of birth. The interventional procedures such as blood-letting and
vaccination are the most important pain sources for the children. The trauma
that pain creates might cause unconformity with the vaccination and the lack of
adherence to therapy. These conditions might cause outbreaks in many
preventable diseases, and leave the children defenseless. Especially in the
infancy period, in which the brain development is fast, the pains arising from
interventional procedures should be well-managed in order to eliminate the
developmental and emotional effects of pain. In pain management, there are many
approaches both pharmacological and non-pharmacological.  It is almost
impossible to use the pharmacological methods due to the reasons such as the
requirement of application by experienced personnel, the complication risk, and
the costs. Some of the non-pharmacological methods used for neonates and
infants are sucrose, holding in inclined position, kangaroo care, mother’s
bosom, lactation, tactile stimulation, and swaddling. This paper was prepared
in order to discuss the interventional procedure pains among the neonates and
infants and the importance of non-pharmacological management of these pains.

References

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Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi

Year 2018, , 169 - 178, 04.04.2018
https://doi.org/10.16948/zktipb.338176

Abstract

Ağrı sağlık durumunu direk etkileyen
kontrol edilmediğinde hayatın bütün alanlarında olumsuz sonuçlar doğuran bir
sorundur. Tüm çocuklara doğumdan itibaren bir dizi girişimsel ağrılı işlem
uygulanmaktadır. Kan alma, enjeksiyon, aşı gibi girişimsel işlemler çocukların
en büyük ağrı kaynaklarındandır. Ağrının yarattığı travma çocuklarda başta iğne
fobisi olmak üzere, aşı uygulamalarında aksaklık, tedaviye uyumda yetersizlik
sebebi olabilir ve bu durumlar önlenebilir birçok hastalıkta salgınlara neden
olarak çocukları savunmasız bırakabilir. Özellikle beyin gelişimin hızlı olduğu
süt çocukluğu döneminde ağrının gelişimsel ve emosyonel etkilerini gidermek
için girişimsel işlem ağrıları iyi yönetilmelidir. Ağrı yönetiminde farmakolojik
ve non-farmakolojik pek çok yaklaşım vardır. Farmakolojik yöntemlerin deneyimli
personel tarafından uygulanma zorunluluğu, komplikasyon riski ve maliyeti
nedeniyle kullanımını nerdeyse imkansızdır. Sükroz, kıvırarak tutmak, anne kucağı, kanguru
bakımı, emzik vermek, taktil uyarı, emzirme, kundaklama kullanılan yenidoğan ve
süt çocukları için kullanılan non-farmakolojik yöntemlerdendir. Bu makale
yenidoğan ve süt çocuğunda girişimsel işlem ağrıları ve bunun non-farmakolojik yönetiminin
önemini vurgulamak için yazılmıştır.

References

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  • 2. Melzack R, Wall P. Pain mechanism: a new theory. Pain Clinic. 1994; 7: 57-72.
  • 3. Coghill RC, McHaffie JG, Yen YF. Neural correlates of interindividual differences in the subjective experience of pain. Proc Natl Acad Sci U S A. 2003; 100: 8538-42.
  • 4. Puchalski M, Hummel P. The reality of neonatal pain. Advances in Neonatal Care. 2002; 2(5) 233-47.
  • 5. Uyar M. Çocukta ağrı ve tedavisi. Turkiye Klinikleri J Int Med Sci. 2006; 2(5) 36- 47.
  • 6. Goodenough B, Kampel L, Champion GD, Laubreaux L, Nicholas MK, Ziegler JB, McInerney M. An investigation of the placebo effect and age related factors in the report of needle pain from venipuncture in children. Pain. 1997; 72(3):383-91.
  • 7. Taddio A, Katz J. The effects of early pain experience in neonates on pain responses in infancy and childhood. Paediatr Drugs. 2005; 7,245–57.
  • 8. Batton DG, Barrington KJ, Wallman C. Prevention and management of pain in the neonate: an update. Pediatrics. 2006; 118:2231–41.
  • 9. Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, Hanrahan A, Ipp M, Lockett D, MacDonald N, Midmer D, Mousmanis P, Palda V, Pielak K, Riddell RP, Rieder M, Scott J, Shah V. Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline CMAJ. 2010 December 14;182(18): 843–55.
  • 10. Schechter NL, Zempsky WT, Cohen LL, McGrath PJ, McMurtry CM, Bright NS. Pain reduction during pediatric immunizations: evidence-based review and recommendations. Pediatrics. 2007;119(5):e1184-98.
  • 11. Tansky C, Lindberg EC. Breastfeeding as a pain intervention when immunizing infants. Journal for Nurse Practitioners. 2010;6(4):287-95.
  • 12. Zeltzer L, Schlank CB. Conquering Your Child’s Chronic Pain, Harper Resource. 2005, New York.
  • 13. Barnhill BJ, Holbert MD, Jackson NM, Erickson RS. (1996). Using pressure to decrease the pain of intramuscular injections. J Pain Symptom Manage. 1996; 12(1):52-8.
  • 14. Chung JW, Ng WM, Wong TK. An experimental study on the use of manual pressure to reduce pain in intramuscular injections. J Clin Nurs. 2002; 11(4):457-61.
  • 15. Yavuz DE, Karabacak U, Yavuz T, Ayhan Yİ. Applying manual pressure prior to benzathine penicillin injection for rheumatic fever prophylaxis reduces pain in children. Pain Manag Nurs. 2015;16 (3):328-35.
  • 16. Shah V, Taddio A, Rieder MJ for the HELPİNG KIDS Team. Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood iomunizations: Systematic review and metaanalyses. Clin Ther. 2009;31(B):104-51.
  • 17. Arnstein P. Multimodal approaches to pain management. Nursing. 2017 Mar; 41(3): 60-1.
  • 18. Young KD. Pediatric procedural pain. Ann Emerg Med. 2005 Feb;45(2):160-171.
  • 19. Anand K, Stevens B, McGrath PJ. Pain in neonates and infants: pain research and clinical management series. New York, USA: Elsevier; 2007.
  • 20. Fitzgerald M, Beggs S. The neurobiology of pain: developmental aspects. Neuroscientist. 2001 Jun;7(3):246-57.
  • 21. Davidson AJ. Neurotoxicity and the need for anesthesia in the newborn: does the emperor have no clothes? Anesthesiology. 2012 Mar;116(3):50750-9.
  • 22. Bhutta AT, Anand KJ. Vulnerability of the developing brain. Neuronal mechanisms. Clin Perinatol. 2002 Sep;29(3):357-72.
  • 23. Fitzgerald M. What do we really know about newborn infant pain? Exp Physiol. 2015 Dec;100(12):1451-7.
  • 24. Soriano SG, Anand KJ. Anesthetics and brain toxicity. Current Opinion in Anesthesiology 2005; 18:293–97.
  • 25. Lundeberg S, Lundeberg T. Pain in infants and children—Physiological background and clinical aspects. Acupuncture and Related Therapies 1 (2013) 46– 9.
  • 26. Fitzgerald M, Walker SM. Infant pain management: a developmental neurobiological approach. Nat Clin Pract Neurol. 2009 Jan;5(1):35-50
  • 27. Fabrizi L, Slater R, Worley A, et al. A Shift in Sensory Processing that Enables the Developing Human Brain to Discriminate Touch from Pain. Current Biology. 2011;21(18):1552-58.
  • 28. Talos DM, Follett PL, Folkerth RD, et al. Developmental regulation of AMPA receptor subunit expression in forebrain and relationship to regional susceptibility to hypoxic/ischemic injury: Part II. Human cerebral white matter and cortex. Steward O, ed. The Journal of comparative neurology. 2006; 497(1):61-77.
  • 29. Johnston CC, Stremler RL, Stevens BJ, Horton LJ. Effectiveness of oral sucrose and simulated rocking on pain response in preterm neonates. Pain. 1997 Aug;72(1-2):193-99.
  • 30. Ruda MA, Ling QD, Hohmann AG, Peng YB, Tachibana T. Altered nociceptive neuronal circuits after neonatal peripheral inflammation. Science. 2000 Jul 28;289(5479):628-31.
  • 31. Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1997 Mar 1;349(9052):599-603.
  • 32. Fabrizi L, Williams G, Lee A, Meek J, Slater R, Olhede S, Fitzgerald M. Cortical activity evoked by an acute painful tissue-damaging stimulus in healthy adult volunteers. J Neurophysiol. 2013 May;109(9):2393-403.
  • 33. Vinall J, Grunau RE. Impact of repeated procedural pain-related stress in infants born very preterm. Pediatr Res. 2014 May;75(5):584-87.
  • 34. Buntinx M, Moreels M, Vandenabeele F, Lambrichts I, Raus J, Steels P, Stinissen P, Ameloot M. Cytokine-induced cell death in human oligodendroglial cell lines: I. Synergistic effects of IFN-gamma and TNF-alpha on apoptosis. J Neurosci Res. 2004 Jun 15;76(6):834-45.
  • 35. Slater L, Asmerom Y, Boskovic DS, Bahjri K, Plank MS, Angeles KR, Phillips R, Deming D, Ashwal S, Hougland K, Fayard E, Angeles DM. Procedural pain and oxidative stress in premature neonates. J Pain. 2012 Jun;13(6):590-97.
  • 36. Brummelte S, Grunau RE, Chau V, Poskitt KJ, Brant R, Vinall J, Gover A, Synnes AR, Miller SP. Procedural pain and brain development in premature newborns. Ann Neurol. 2012 Mar;71(3):385-96.
  • 37. Dührsen L, Simons SH, Dzietko M, Genz K, Bendix I, Boos V, Sifringer M, Tibboel D, Felderhoff-Mueser U. Effects of repetitive exposure to pain and morphine treatment on the neonatal rat brain. Neonatology. 2013;103(1):35-43.
  • 38. Ranger M, Chau CM, Garg A, Woodward TS, Beg MF, Bjornson B, Poskitt K, Fitzpatrick K, Synnes AR, Miller SP, Grunau RE. Neonatal pain-related stress predicts cortical thickness at age 7 years in children born very preterm. PloS One. 2013 Oct 18;8(10):76702.
  • 39. Ranger M, Grunau RE. Early repetitive pain in preterm infants in relation to the developing brain. Pain Manag. 2014 Jan;4(1):57-67.
  • 40. Doesburg SM, Chau CM, Cheung TP, Moiseev A, Ribary U, Herdman AT, Miller SP, Cepeda IL, Synnes A, Grunau RE. Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestational age. Pain. 2013 Oct;154(10):1946-52.
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There are 78 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Derya Emre Yavuz

Şule Ecevit Alpar

Publication Date April 4, 2018
Published in Issue Year 2018

Cite

APA Emre Yavuz, D., & Ecevit Alpar, Ş. (2018). Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi. Zeynep Kamil Tıp Bülteni, 49(1), 169-178. https://doi.org/10.16948/zktipb.338176
AMA Emre Yavuz D, Ecevit Alpar Ş. Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi. Zeynep Kamil Tıp Bülteni. April 2018;49(1):169-178. doi:10.16948/zktipb.338176
Chicago Emre Yavuz, Derya, and Şule Ecevit Alpar. “Yenidoğan Ve Süt Çocuklarında Girişimsel Ağrı Ve Non-Farmakolojik Yönetimi”. Zeynep Kamil Tıp Bülteni 49, no. 1 (April 2018): 169-78. https://doi.org/10.16948/zktipb.338176.
EndNote Emre Yavuz D, Ecevit Alpar Ş (April 1, 2018) Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi. Zeynep Kamil Tıp Bülteni 49 1 169–178.
IEEE D. Emre Yavuz and Ş. Ecevit Alpar, “Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi”, Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, pp. 169–178, 2018, doi: 10.16948/zktipb.338176.
ISNAD Emre Yavuz, Derya - Ecevit Alpar, Şule. “Yenidoğan Ve Süt Çocuklarında Girişimsel Ağrı Ve Non-Farmakolojik Yönetimi”. Zeynep Kamil Tıp Bülteni 49/1 (April 2018), 169-178. https://doi.org/10.16948/zktipb.338176.
JAMA Emre Yavuz D, Ecevit Alpar Ş. Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi. Zeynep Kamil Tıp Bülteni. 2018;49:169–178.
MLA Emre Yavuz, Derya and Şule Ecevit Alpar. “Yenidoğan Ve Süt Çocuklarında Girişimsel Ağrı Ve Non-Farmakolojik Yönetimi”. Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, 2018, pp. 169-78, doi:10.16948/zktipb.338176.
Vancouver Emre Yavuz D, Ecevit Alpar Ş. Yenidoğan ve Süt Çocuklarında Girişimsel Ağrı ve Non-farmakolojik Yönetimi. Zeynep Kamil Tıp Bülteni. 2018;49(1):169-78.