Schmerzempfinden bei Säuglingen

Ich verlinke hier die PP-Präsentation eines Workshops der Universität Basel aus dem letzten Jahr mit dem Titel " Vom verkannten Schmerz bei Neugeborenen hin zur Schmerzlinderung durch die Eltern".

Ich finde diese Präsentation sehr anrührend. Sie stellt auch die Problematik allgemeinverständlich und praxisnah dar. Überzeugend finde ich auch den Ansatz, die Eltern miteinzubeziehen.
Ob das alles medizinisch korrekt ist, kann ich nicht beurteilen. Kritisch muss man sicher die Hervorhebung von Sucrose für die Schmerzbekämpfung sehen. Immerhin wird die Untersuchung von Rebeccah Slater an prominenter Stelle ausdrücklich erwähnt. Immerhin!

https://www.luks.ch/uploads/media/…en_Cignacco.pdf

Guideline Statement: Management of Procedure-related Pain in Neonates - 2005

Zitat

"7.Sedation does not provide pain relief and may mask the neonate's
response to pain.
...

10.A lack of behavioural responses (including crying and movement) does
not necessarily indicate a lack of pain.

http://www.racp.edu.au/download.cfm?d…ldname=filename

Good Practice in Postoperative and Procedural Pain Management
2nd Edition, 2012

A Guideline from the Association of Paediatric Anaesthetists of Great Britain and Ireland

Zitat

Procedural pain in the neonate

-Blood Sampling including percutaneous central venous catheter insertion
-Ocular examination for retinopathy of prematurity (ROP)
-Lumbar puncture
-Urine sampling
-Chest drain (tube) insertion and removal
-Nasogastric tube placement
-Immunization and intramuscular injection

General surgery and urology
....
Circumcision
....

Circumcision is regarded as a relatively minor surgical procedure, but it may be associated with significant postoperative pain and distress.

However, for neonatal circumcision, no single technique has been shown to reliably alleviate pain in the awake patient, which therefore presents a clinical challenge.

Postoperative pain after circumcision in the neonate has not been well investigated, and available studies have all examined pain during the procedure in awake neonates. It has been suggested that the procedure be performed in awake infants only during the first week of life as pain scores during the procedure have been shown to increase to unacceptable levels with increasing neonatal age. For all techniques studied, there was a significant failure rate.

Overall, there are insufficient data to evaluate the use of supplementary analgesia in either the early or late postoperative period."

Alles anzeigen

http://onlinelibrary.wiley.com/store/10.1111/…v=1&t=hk9j1llr&