基于振动的减轻新生儿和婴儿皮肤穿刺毒性诱发反应:随机对照试验。

IF 3.9 2区 医学 Q1 PEDIATRICS
Lance M Relland, Caitlin P Kjeldsen, Arnaud Jeanvoine, Lelia Emery, Kathleen Adderley, Rachelle Srinivas, Maeve McLoughlin, Nathalie L Maitre
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引用次数: 0

摘要

研究目的评估非毒性振动刺激对皮肤穿刺的毒性诱发皮层反应的影响,并确定某些行为成分的存在是否可用于预测此类皮层反应:随机对照试验:地点:一家独立儿童医院的四级新生儿重症监护室:134名住院婴儿,年龄介于月经后36周至52周之间,并被要求接受临床所需的实验室抽血:干预措施:婴儿随机接受干预措施,即在脚跟扎针前 10 秒开始在皮肤穿刺部位进行振动刺激;或接受对照措施,即不进行振动刺激:主要结果测量:脑电图和视频记录,时间与皮肤穿刺针的部署时间锁定。兴奋诱发的皮层反应通过皮肤穿刺对侧躯体感觉区的曲线下面积进行测量。行为反应通过视频分析进行编码:结果:与对照组相比,接受振动刺激的参与者兴奋诱发的皮层反应明显减少(额叶,p=0.0088;中央顶叶,p=0.0111)。各组之间的行为反应无明显差异(均为 p>0.05):结论:在皮肤穿刺前和穿刺过程中同时出现的非毒性振动刺激可明显减轻住院婴儿的痛觉反应。面部表情成分的存在与否不足以可靠地预测大脑中的疼痛信号:NCT04050384.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vibration-based mitigation of noxious-evoked responses to skin puncture in neonates and infants: a randomised controlled trial.

Objective: To assess the effect of a non-noxious vibratory stimulus on noxious-evoked cortical responses to skin puncture and to determine whether the presence of certain behavioural components may be used to predict such cortical responses.

Design: Randomised controlled trial.

Setting: Level IV neonatal intensive care unit at a stand-alone children's hospital.

Patients: 134 hospitalised infants between 36 and 52 weeks' postmenstrual age and ordered to receive a clinically required laboratory draw.

Interventions: Infants randomised to receive the intervention, a vibratory stimulus at the site of skin puncture beginning 10 s prior to a heel stick, or the control, no vibration.

Main outcome measures: Electroencephalography and video recording time-locked to the deployment of the lancet for the skin puncture. Noxious-evoked cortical responses were measured by the area under the curve in the somatosensory region contralateral to the skin puncture. Behavioural responses were coded through video analysis.

Results: Noxious-evoked cortical responses were significantly reduced in participants receiving the vibratory stimulus compared with the control (frontal, p<0.0001; central, p=0.0088; central-parietal, p=0.0111). There were no significant differences in behavioural responses between groups (all p>0.05).

Conclusions: A non-noxious vibratory stimulus presented prior to and continuing simultaneously with skin puncture significantly mitigates nociception in hospitalised infants. The presence or absence of facial expression components is inadequate to reliably predict pain signalling in the brain.

Trial registration number: NCT04050384.

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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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