_PAIN IN BABIES 10301010046 宋子贤.

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Presentation transcript:

_PAIN IN BABIES 10301010046 宋子贤

Why they cry? Hungry? Unhappy? Diaper is wet? Noisy? Pain

Effects of pain Inadequate oxygen supply Increased requirement for oxygen Reduction in the efficiency of gas exchange in the lungs Cause a rise in stomach acidity May be aspirated into the lung Reduced efficiency of the immune system Increased morbidity and mortality Aggression and self-destructive behavior, including suicide

Specialty Lower threshold to stimulation They cannot tell

Diagnosis Crying Irritable Disturbed sleep pattern Feeds poorly Fearful, distrustful reaction Blood pressure and stress hormone levels

ChIPPS (Children and Infants Postoperative Pain Scale) Item Score 0 Score 1 Score 2 Crying None Moaning Screaming Facial expression Relaxed smiling Wry mouth Grimacing Posture of the trunk Neutral Variable Rear up Posture of the legs Kicking Tightened Motor restlessness Moderate Restless 0 - 3 No requirement for treating pain, 4 - 10 Progressively greater need for analgesia.

Treatment Measures not involving medication Comforting Oral stimulation Oral sugar Other techniques

Treatment Measures involving medication Local anesthetics Analgesics Side effects

References Anand KJS, Sippell WG, Aynsley-Green A. Randomized trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on stress response. Lancet 1987;1:62-66. Anand KJS, Scalzo FM. Can Adverse Neonatal Experiences Alter Brain Development and Subsequent Behavior? Biology of the Neonate, 2000: 77(2); 69-82 Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. The New England Journal Of Medicine, 1987, Volume 317, Number 21: Pages 1321-1329. Anand KJS, et al. Summary Proceedings From the Neonatal Pain-Control Group. Pediatrics, 2006, Vol. 117 No. 3, pp. S9-S22 doi:10.1542/peds.2005-0620C. Fitzgerald M, Beggs S. The neurobiology of pain: developmental aspects. Neuroscientist. 2001;7:246-57. Howard RF. Developmental Factors and Acute Pain in Children. in Pain 2005 – An Updated Review: Refresher Course Syllabus, ed. Justins DM. IASP Press, Seattle, 2005. "IASP definition, full entry". Retrieved 6 October 2009. This often quoted definition was first formulated by an IASP Subcommittee on Taxonomy: Bonica, JJ (1979). "The need of a taxonomy.". Pain 6 (3): 247–252. doi:10.1016/0304-3959(79)90046-0. ISSN 0304-3959. PMID 460931. It is derived from Harold Merskey's 1964 definition: "An unpleasant experience that we primarily associate with tissue damage or describe in terms of tissue damage or both." Merskey, H (1964). An Investigation of pain in psychological illness, DM Thesis. Oxford University. Koeslag J. The Human Lifecycle, Part 19. Development Of Communication. Division of Medical Physiology, Department of Biomedical Sciences, University of Stellenbosch. Online version Zeskind PS. Cross-Cultural Differences in Maternal Perceptions of Cries of Low- and High-Risk Infants. Child Development, 1983;Vol. 54, No. 5, 1119-1128. DOI 10.2307/1129668 Online Version Buttner W, Finke W. Analysis of behavioral and physiological parameters for the assessment of postoperative analgesic demand in newborns, infants and young children: a comprehensive report on seven consecutive studies. Paediatric Anaesthesia. 2000; 10: 303-318.

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