Pediatrics
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Randomized Controlled Trial Clinical Trial
Skin-to-skin contact is analgesic in healthy newborns.
To determine whether skin-to-skin contact between mothers and their newborns will reduce the pain experienced by the infant during heel lance. ⋯ Skin-to-skin contact is a remarkably potent intervention against the pain experienced during heel stick in newborns.
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Randomized Controlled Trial Clinical Trial
Midazolam nasal spray reduces procedural anxiety in children.
Anxiety and pain even in minor procedures are still great problems in pediatrics, not least in pediatric oncology. Conscious sedation is indicated when other means to overcome a child's fear fail. The aim of this study was to investigate whether intranasal administration of midazolam given before insertion of a needle in a subcutaneously implanted central venous port could reduce anxiety, discomfort, pain, and procedure problems. ⋯ Nasal midazolam spray offers relief to children anxious about procedures, such as insertion of a needle in a subcutaneously implanted intravenous port, venous blood sampling, venous cannulation, etc. Its use, however, may be limited by nasal discomfort in some patients for whom rectal and oral routes might be alternatives.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial.
Disagreement exists concerning the appropriate delivery room management of the airway of vigorous meconium-stained infants. Some suggest a universal approach to intubation and suctioning of the airway in all such neonates, whereas others advocate a selective approach. We performed this investigation: 1) to assess whether intubation and suctioning of apparently vigorous, meconium-stained neonates would reduce the incidence of meconium aspiration syndrome (MAS); and 2) to determine the frequency of complications from delivery room intubation and suctioning of such infants. ⋯ Compared with expectant management, intubation and suctioning of the apparently vigorous meconium-stained infant does not result in a decreased incidence of MAS or other respiratory disorders. Complications of intubation are infrequent and short-lived.
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Randomized Controlled Trial Clinical Trial
Intrapartum maternal fever and neonatal outcome.
Much of fever during term labor may not be infectious but rather a consequence of the use of epidural analgesia. Therefore, we investigated the association of elevated maternal intrapartum temperature with neonatal outcome when the infant does not develop an infection. ⋯ Intrapartum maternal fever, particularly if >101 degrees F, was associated with a number of apparently transient adverse effects in the newborn. Larger studies are needed to investigate the association of intrapartum fever with neonatal seizures and to determine whether any lasting injury to the fetus may occur.