Assessment of Prolonged Pain Severity in Newborn Infants with Tube Thoracostomy Receiving Paracetamol or Fentanyl Treatment with EDIN Scale

Yıl 2019, Cilt: 16 Sayı: 1, 27 - 30, 01.01.2019

Mehmet Büyüktiryaki Nilüfer Okur Handan Bezirganoğlu Şerife Suna Oğuz Nurdan Uraş

Öz

Aim: The aim of this study was to assess the severity of pain in preterm infants who underwent tube thoracostomy with pneumothorax and EDIN scales and to investigate the effect of two different analgesic treatments paracetamol or fentanyl on the EDIN scores.Material and Methods: Between January 2014 and December 2015, infants who had a gestational age of 32-37 weeks and underwent tube thoracostomy with pneumothorax were evaluated for compliance. EDIN scale was applied by two experienced nurses and scores were recorded in 6 hours. Infants receiving paracetamol or fentanyl as an analgesic treatment were studied in 2 groups.Results: A total of 50 infants were analyzed, 27 with paracetamol treatment and 23 with fentanyl treatment. There was no difference between the first EDIN scores 9 and 8 p> 0.01 respectively . The EDIN score recorded at the 6th hour was significantly lower in the fentanyl group 5 and 7, p

Anahtar Kelimeler

EDIN scale, fentanyl, paracetamol, premature, prolonged pain

Parasetamol veya Fentanil Tedavisi Alan Tüp Torakostomili Yenidoğan Bebeklerde Uzamış Ağrı Şiddetinin EDIN Ölçeği İle Değerlendirilmesi

Öz

Amaç: Pnömotoraks tanısı ile tüp torakostomi uygulanan preterm bebeklerde ağrı şiddetinin EDIN ölçeği ile değerlendirilmesi ve uygulanan iki farklı analjezik tedavinin parasetamol veya fentanil EDIN skorları üzerine etkisinin araştırılmasıdır.Gereç ve Yöntemler: Ocak 2014-Aralık 2015 tarihleri arasında gebelik yaşı 32-37 hafta olan ve pnömotoraks tanısı ile tüp torakostomi uygulanan bebekler uygunluk açısından değerlendirildi. İki deneyimli hemşire tarafından EDIN ölçeği uygulandı ve 6 saatte bir skorlar kaydedildi. Analjezik tedavi olarak parasetamol veya fentanil alan bebekler 2 grupta incelendi.Bulgular: Parasetamol tedavisi alan 27 ve fentanil tedavisi alan 23 bebek olmak üzere toplam 50 bebek analiz edildi. İlk EDIN skorları arasında gruplar arasında fark saptanmadı sırasıyla; 9 ve 8 p>0.01 . İkinci 6. Saatte kaydedilen EDIN skoru fentanil grubunda anlamlı düşük saptandı 5 ve 7, p

Anahtar Kelimeler

EDIN skala, fentanil, parasetamol, prematüre, uzamış ağrı

Kaynakça

• Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008;300:60-70.
• van Ganzewinkel CJ, Anand KJ, Kramer BW, Andriessen P. Chronic pain in the newborn: toward a definition. Clin J Pain. 2014;30:970-7.
• Debillon T, Zupan V, Ravault N, Magny JF, Dehan M. Development and ini- tial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2001;85:F36-41.
• Anand KJ; International Evidence-Based Group for Neonatal Pain. Con- sensus statement for the prevention and management of pain in the new- born. Arch Pediatr Adolesc Med. 2001;155:173.
• Schmidt B, Adelmann C, Stützer H, Welzing L, Hünseler C, Kribs A, et al. Comparison of sufentanil versus fentanyl in ventilated term neonates. Klin Padiatr. 2010;222:62.
• Pacifici GM. Clinical pharmacology of fentanyl in preterm infants. A re- view. Pediatr Neonatol. 2015;56:143-8.
• Ceelie I, de Wildt SN, van Dijk M, van den Berg MM, van den Bosch GE, Duivenvoorden HJ, et al. Effect of intravenous paracetamol on postope- rative morphine requirements in neonates and infants undergoing major noncardiac surgery: a randomized controlled trial. JAMA. 2013;309:149- 54.
• Perrott DA, Piira T, Goodenough B, Champion GD. Efficacy and safety of acetaminophen vs ibuprofen for treating children’s pain or fever: a me- ta-analysis. Arch Pediatr Adolesc Med. 2004;158:521.
• Bonetto G, Salvatico E, Varela N, Cometto C, Gómez PF, Calvo B. Pain prevention in term neonates: randomized trial for three methods. Archivos Argentinos de Pediatría 2008;106:392-6.
• Kabataş EU, Dursun A, Beken S, Dilli D, Zenciroğlu A, Okumuş N. Efficacy of Single Dose Oral Paracetamol in Reducing Pain During Examination for Retinopathy of Prematurity: A Blinded Randomized Controlled Trial. Indian J Pediatr. 2016;83:22-6.
• Härmä A, Aikio O, Hallman M, Saarela T. Intravenous Paracetamol Dec- reases Requirements of Morphine in Very Preterm Infants. J Pediatr. 2016;168:36-40.
• Ohlsson A, Shah PS. Paracetamol (acetaminophen) for preventi- on or treatment of pain in newborns. Cochrane Database Syst Rev. 2016;10:CD011219.
• Ancora G, Lago P, Garetti E, Pirelli A, Merazzi D, Mastrocola M, et al. Efficacy and safety of continuous infusion of fentanyl for pain control in preterm newborns on mechanical ventilation. J Pediatr. 2013;163:645- 51.
• Guinsburg R, Kopelman BI, Anand KJ, de Almeida MF, Peres Cde A, Mi- yoshi MH. Physiological, hormonal, and behavioral responses to a sing- le fentanyl dose in intubated and ventilated preterm neonates. J Pediatr 1998;132:954e9.
• Vaughn PR, Townsend SF, Thilo EH, McKenzie S, Moreland S, Denver KK. Comparison of continuous infusion of fentanyl to bolus dosing in neona- tes after surgery. J Pediatr Surg. 1996;31:1616e23.
• Faye PM, De Jonckheere J, Logier R, Kuissi E, Jeanne M, Rakza T, et al. Newborn infant pain assessment using heart rate variability analysis. Clin J Pain. 2010;26:777-82.
• Ancora G, Mastrocola M, Bagnara C, Zola D, Pierantoni L, Rossi G, et al. Influence of gestational age on the EDIN score: an observational study. Arch Dis Child Fetal Neonatal Ed. 2009;94:F35-8.