Gutiérrez-Padilla JA, Padilla-Muñoz H, Rodríguez-Aceves G, Castañeda-Castañeda P, Ramírez-Ramírez FJ, García-Hernández H, López-Gallo L, Raygoza-Jurado A, Gómez-Reyes M, Moreno-Torres L, Díaz-Valdivia J, Martínez-Verónica R, Gutiérrez-González H, Ávalos-Huizar LM, Pérez Rulfo-Ibarra D, Rosales-González N

Language: Spanish
References: 18
Page: 195-200
PDF size: 548.92 Kb.

ABSTRACT

Introduction. The pain in newborns has been intensely studied and is identified in newborns identified in the ICU as a cause of alteration at different levels in the patients. In the ENICU in the Fray Antonio Alcalde Civil Hospital of Guadalajara there is a multidisciplinary program available for the prevention, control and handling of pain in the newborns admitted, using both non-pharmacological and pharmacological interventions in accord with international protocols. Hence, this article is presented with the objective of knowing the clinical results and procedures most related to pain, as well as clinical practices and non-pharmacological therapeutic actions applied in our unit.
Material y Methods. An analytical, prospective study recruiting the total of newborns admitted to the ENICU from January 1st 2012 to January 31st 2014. From a total of 992 patients who were assessed with CRIES. Whether it was pharmacological or non-pharmacological treatment was established by the neonatologist and/or anesthesiologist in the clinic of pain. The main variables studied were: The number of heel punctures, the number of catheters used for infusion or umbilical catheters, endotracheal intubation procedures or assisted ventilation, pleural effusion tubes and lumbar punctures. The data analysis was made in Epiinfo and graphs in Excel.
Results. 8670 heel punctures, 3400 punctures for infusion and umbilical catheters, 420 patients with endotracheal intubation, 55 tubes of preural efussion and 38 lumbar punctures. In 653 patients (66%) non-pharmacological measures were taken, while in 339 (34%) some drugs were used. Non pharmacological measures including the facilitating folding applied on 90% (n=587), Pulse oximetry measuring to avoid punctures for blood gas sampling 88% (n=575), diminishing the excessive exposure to light in 84% (n=547), noise decreasing 50% (n=326), breast milk 36% (n=236). 209 patients (62%) were administered propofol and acetaminophen. Fentanyl in 85% (n=110), midazolam in 72% (n=93), tramadol 18.5% (24%), rocuronium in 7% (9%), vecuronium and morphine in 6% (n=8), diazepam and buprenorphine in 3.8% (n=5) of the cases.
Discussion. The prevention and handling of pain in our ICU is similar to the one in other hospital units in the world. It is necessary to re-educate the staff in the use of sucrose due to the high number of procedures that originate pain and could be avoided by this compound. It is convenient to promote information on the health staff in order to prevent and/or cause pain the critical condition newborns.

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