PREMATÜRE RETİNOPATİSİ MUAYENESİNDE ÇOKLU DUYUSAL UYARIMIN YENİDOĞAN GİRİŞİMSEL AĞRISI ÜZERİNDEKİ ETKİSİ: RANDOMİZE KONTROLLÜ ÇALIŞMA

Öz

Amaç Prematüre yenidoğanlarda sıkça uygulanan girişimlerden biri de prematüre retinopatisi muayenesidir. Bu muayenenin yenidoğanlar için ağrılı bir işlem olduğu, prematüre yenidoğanlarda ağrıya bağlı bir takım fizyolojik ve davranışsal değişikliklere yol açabileceği bilinmektedir. Bu çalışmada, prematüre yenidoğanlarda prematüre retinopati taraması amacıyla uygulanan göz muayenesi sırasında uygulanabilecek olan çoklu duyusal uyarımın girişimsel ağrı üzerindeki etkisini ortaya koymak amaçlanmıştır. Gereç ve Yöntem Bu çalışma uygulayıcı ve değerlendirici kör, randomize kontrollü bir klinik çalışma olarak tasarlanmıştır. Çalışma toplamda 60 prematüre yenidoğanla yürütülmüştür. Müdahale grubuna göz muayenesi başlamadan üç dakika önce çoklu duyusal uyarım programı uygulanırken, kontrol grubuna ek bir girişim uygulanmaksızın rutin bakım uygulanmıştır. Birincil sonuç ölçütü için Yenidoğan Ağrı Profili kullanılmıştır. İkincil sonuç ölçütleri ise kalp atım hızı ve oksijen doygunluğunu içermektedir. Veriler SPSS yazılımı (sürüm 23) kullanılarak analiz edilmiştir. Bulgular Çalışmada müdahale öncesi her iki grupta da ağrı skorları istatistik olarak benzer bulundu (Kontrol grubu: 3,6 ± 1,7, Girişim grubu: 3,2 ± 1,4, p=0,401) Göz muayenesi sırasında ve muayene sonrasında ağrı skorları açısından iki grubun faklı olduğu saptandı (p<0,05). Muayenenin bitiminden hemen sonra çoklu duyusal uyarım grubundaki yenidoğanların ağrı skorları ortalaması 6.8 ± 1.5, kontrol grubunda ise bu skor 10,3 ± 1,4 olarak saptanmıştır (p<0,001). Kalp atım hızı ve oksijen doygunluğu değişkenlerinde ise yine ağrı skoruna benzer şekilde iki grup arasında anlamlı fark saptandı. Sonuç Çoklu duyusal uyarım programı prematüre retinopatisi muayenelerinde yenidoğanlar için ağrıyı azaltmada etkili ve güvenli, farmakolojik olmayan etkin bir yol olarak kullanılabilir.

Anahtar Kelimeler

• Ağrı
• Çoklu duyusal uyarım
• Prematüre retinopatisi
• Yaşam bulgusu

THE EFFECT OF MULTI-SENSORY STIMULATION ON NEONATAL INTERVENTIONAL PAIN IN EXAMINATION FOR PREMATURE RETINOPATHY: A RANDOMIZED CONTROLLED TRIAL

Öz

Objective One of the most frequently performed interventions in premature newborns is the examination for retinopathy of prematurity. It is known that this examination is a painful procedure for newborns and may cause some physiological and behavioral changes related to pain in premature newborns. This study aimed to reveal the effect of multi-sensory stimulation on interventional pain, which will be applied during the eye examination for premature retinopathy screening in premature newborns. Material and Method This study was designed as a practitioner- and assessor-blind randomized controlled clinical trial. The study was conducted with 60 premature newborns in total. While the multi-sensory stimulation program was applied to the intervention group three minutes before the eye examination, routine care was applied to the control group without any additional intervention. The Neonatal Pain Profile was used as the primary outcome measure. Secondary outcome measures include heart rate and oxygen saturation. Data were analyzed using SPSS (version 23) software. Results In the study, pain scores in both groups were found to be statistically similar before the intervention (Control group: 3.6 ± 1.7, Intervention group: 3.2 ± 1.4, p=0.401) It was determined that the two groups were different in terms of pain scores during and after the eye examination (p<0,05). Immediately after the end of the examination, the mean pain scores of the newborns in the multisensory stimulation group were 6.8 ± 1.5, and this score was 10.3 ± 1.4 in the control group (p<0.001). Like the pain score, the two groups had a significant difference in the heart rate and oxygen saturation variables. Conclusion Multisensory stimulation programs can be used as an effective, safe, non-pharmacological way to reduce pain for newborns in retinopathy of prematurity examinations.

Anahtar Kelimeler

• Multi-sensory stimulations
• pain
• vital signs
• retinopathy of prematurity

Kaynakça

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