Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Review Randomized Controlled Trial
The analgesic properties of intraoral sucrose: an integrative review.
The treatment of pain is an essential component of the clinical and ethical care of infants. Despite evidence-based practice consensus statements recommending that infants receive analgesia during minor painful procedures, numerous studies have shown that procedural pain remains poorly managed in this population. ⋯ The objective of this integrative review is to synthesize findings from published randomized controlled trials evaluating the efficacy and safety of oral sucrose as a preprocedural intervention for mild to moderate procedural pain in infants. Overall, studies indicate that oral sucrose is an effective, safe, convenient, and immediate-acting analgesic for reducing crying time and significantly decreases biobehavioral pain response following painful procedures with infants.
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Randomized Controlled Trial Clinical Trial
A pilot study of changes in cerebral blood flow velocity, resistance, and vital signs following a painful stimulus in the premature infant.
The purpose of this pilot study was to determine the cerebral blood flow velocity and resistance changes and vital signs following a painful stimulus in the premature infant. ⋯ This is a study based on a small sample size. However, the Doppler-measured peak systolic velocity increases significantly after a painful stimulus. The clinical implication of this finding needs to be established.
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Randomized Controlled Trial
Randomized controlled trial evaluating the effects of cobedding on weight gain and physiologic regulation in preterm twins in the NICU.
To compare the differences in growth and physiologic regulation in cobedded preterm twins versus individually bedded preterm twins while in the neonatal intensive care unit (NICU). ⋯ A greater increase in mean weight gain was noted in the cobedded group compared to the control group.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial evaluating the efficacy of tetracaine gel for pain relief from peripherally inserted central catheters in infants.
Insertion of peripherally inserted central catheters (PICC) is a commonly performed procedure in both preterm and term infants. Tetracaine 4% gel (Ametop; Smith & Nephew Inc, St. Laurent, Quebec), a topical anesthetic, although reported to be effective for reducing the pain of venipuncture in neonates, has not been investigated for the management of pain associated with the PICC procedure. ⋯ Tetracaine gel was not effective for pain relief for PICC insertion in infants. Its use for pain relief cannot be recommended based on the results of this study. Other pharmacologic, behavioral, and physical interventions should be investigated for safety and relief of procedural pain in this population of infants.
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Randomized Controlled Trial Clinical Trial
The influence of gestational age on the efficacy and short-term safety of sucrose for procedural pain relief.
Physiologic and behavioral responses to procedural pain are influenced by gestational age (GA). Compared with term neonates, hospitalized preterm neonates are subjected to more painful procedures aimed at improving their clinical outcome. Although several trials to determine the efficacy of sucrose for managing procedural pain have been conducted, none have examined the influence of GA. ⋯ In a secondary analysis of a larger RCT, sucrose and NNS was the most efficacious intervention for single heel lances in each of 3 GA groups. However, infants of lower GA experienced more adverse events. Research on the efficacy and safety of repeated doses of oral sucrose, tested in infants from a wide range of GA, is required.