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Danwen Wang - One of the best experts on this subject based on the ideXlab platform.
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Efficacy and safety of repeated oral sucrose for repeated Procedural Pain in neonates: A systematic review.
International journal of nursing studies, 2016Co-Authors: Haixia Gao, Honglian Gao, Hua Zhang, Danwen WangAbstract:Abstract Background Although sucrose is most extensively examined for its analgesia effect on a single Procedural Pain, neonates in neonatal intensive care units can be exposed to numerous Painful procedures every day requiring multiple doses of sucrose. Some experiments have been performed to examine the efficacy and safety of repeated sucrose administration for repeated Procedural Pain; however, a systematic review of this topic has not yet been carried out. Objective To identify and assess the evidence demonstrating the efficacy and safety of repeated sucrose for repeated Procedural Pain in neonates. Method A systematic review was conducted using the Cochrane methodology. Pubmed, Cochrane Library, Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CBMdisc, CNKI, VIP, and Wanfang databases were searched through December 2015. All related abstracts were reviewed and the full texts of relevant articles were studied. Randomized controlled trials (RCTs) were included. Risk of bias was assessed for RCTs using quality critical appraisal criteria recommended by Cochrane Handbook. A standardised data form was used to extract information. Results Eight RCTs met our inclusion criteria. Different study designs were used in the included RCTs, which did not allow us to carry out a meta-analysis. The findings from this review indicated that repeated sucrose was effective in reducing both behavioral Pain response and composite Pain scores during repeated Procedural Pain. However, as for physiological Pain response, one trial found less variability in physiological Pain response for term neonates in the sucrose group than the sterile water group, while two trials demonstrated repeated sucrose was inefficacious for preterm neonates. Regarding the clinical outcomes, no study reported adverse effects related to the repeated sucrose administration. Regarding the neurobehavioral development, two trials reported repeated sucrose for repeated Procedural Pain would not lead to poor neurologic development, while one trial reported that preterm infants 10 doses of sucrose per 24h in the first week of life had poorer neurologic development compared with infants who received fewer sucrose doses. What's more, no study reported the long-term neurobehavioral development outcome of neonates who repeatedly received sucrose across repeated Procedural Pain. Conclusion Evidence regarding the efficacy and safety of repeated sucrose across repeated Procedural Pain for neonates is limited. More prospective, multi-centered, large randomized controlled clinical trials with a standardised study design are required before sucrose can be recommended widely as an analgesia for repeated Procedural Pain in neonates.
Jiao Sun - One of the best experts on this subject based on the ideXlab platform.
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Efficacy and safety of combined nonpharmacological interventions for repeated Procedural Pain in preterm neonates: A systematic review of randomized controlled trials.
International journal of nursing studies, 2019Co-Authors: Wenjie Guo, Xinmei Liu, Xue Zhou, Jiao SunAbstract:Abstract Introduction Premature infants undergo numerous Painful procedures during hospitalization. Some trials have examined the effectiveness and safety of combined nonpharmacological interventions in which two or more non-pharmacological interventions are used simultaneously or continuously to relieve repeated Procedural Pain via multisensory stimulation in preterm neonates. However, a systematic review of this topic has not yet been carried out. Objective To review the evidence on the efficacy and safety of combined nonpharmacological interventions for repeated Procedural Pain in preterm neonates. Method Eight databases were searched using keywords to identify peer-reviewed journal articles in English or Chinese. Randomized controlled trials (RCTs) focusing on combined nonpharmacological interventions for repeated Procedural Pain in preterm neonates published from database inception until May 2019 were included. Results Eight RCTs were retrieved that included ten different combined nonpharmacological interventions. Different study designs were used in the included trials, which did not allow us to carry out a meta-analysis. The findings from the included articles were categorized in terms of efficacy and safety. With respect to efficacy, 1. two trials reported that combined nonpharmacological interventions were more effective than usual care during Painful procedures; 2. three trials reported that combined nonpharmacological interventions were more effective than single nonpharmacological interventions; 3. three trials reported the effects of different combinations of nonpharmacological interventions and found that their effect depends on intervention type rather than number of interventions. Only four trials reported on safety, and they found that combined nonpharmacological interventions were safe for repeated Procedural Pain in preterm neonates. Conclusion According to the literature, combined nonpharmacological interventions may be effective and safe for repeated Procedural Pain in premature infants. However, due to the diversity of interventions included in this systematic review, the evidence is not strong enough to produce a best practice guideline. Further research is needed with larger sample sizes and less heterogeneity to adequately explore the efficacy and safety of combined nonpharmacological interventions for repeated Procedural Pain in premature infants.
Bonnie Stevens - One of the best experts on this subject based on the ideXlab platform.
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Procedural Pain in neonatal units in Kenya
Archives of disease in childhood. Fetal and neonatal edition, 2014Co-Authors: O'brien Munyao Kyololo, Bonnie Stevens, Denise Gastaldo, Peter GisoreAbstract:Objectives To determine the nature and frequency of Painful procedures and Procedural Pain management practices in neonatal units in Kenya. Design Cross-sectional survey. Setting Level I and level II neonatal units in Kenya. Patients Ninety-five term and preterm neonates from seven neonatal units. Methods Medical records of neonates admitted for at least 24 h were reviewed to determine the nature and frequency of Painful procedures performed in the 24 h period preceding data collection (6:00 to 6:00) as well as the Pain management interventions (eg, morphine, breastfeeding, skin-to-skin contact, containment, non-nutritive sucking) that accompanied each procedure. Results Neonates experienced a total of 404 Painful procedures over a 24 h period (mean=4.3, SD 2.0; range 1–12); 270 tissue-damaging (mean=2.85, SD 1.1; range 1–6) and 134 non-tissue-damaging procedures (mean=1.41, SD 1.2; range 0–6). Peripheral cannula insertion (27%) and intramuscular injections (22%) were the most common Painful procedures. Ventilated neonates and neonates admitted in level II neonatal units had a higher number of Painful procedures than those admitted in level I units (mean 4.76 vs 2.96). Only one procedure had a Pain intensity score documented; and none had been performed with any form of analgesia. Conclusions Neonates in Kenya were exposed to numerous tissue-damaging and non-tissue-damaging procedures without any form of analgesia. Our findings suggest that education is needed on how to assess and manage Procedural Pain in neonatal units in Kenya.
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pediatric clinical practice guidelines for acute Procedural Pain a systematic review
Pediatrics, 2014Co-Authors: Grace Lee, O'brien Munyao Kyololo, Janet Yamada, Allyson Shorkey, Bonnie StevensAbstract:BACKGROUND: Procedural Pain assessment and management have been extensively studied through multiple research studies over the past decade. Results of this research have been included in numerous pediatric Pain practice guidelines. OBJECTIVE: To systematically review the quality of existing practice guidelines for acute Procedural Pain in children and provide recommendations for their use. METHODS: A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Scopus from 2000 to July 2013. A gray literature search was also conducted through the Translating Research Into Practice database, Guidelines International Network database, and National Guideline Clearinghouse. Four reviewers rated relevant guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Screening of guidelines, assessment of methodological quality, and data abstraction were conducted by 2 pairs of raters. Disagreements in overall assessments were resolved through consensus. RESULTS: Eighteen guidelines from 4930 retrieved abstracts were included in this study. Based on the AGREE II domains, the guidelines generally scored high in the scope and purpose and clarity of presentation areas. Information on the rigor of guideline development, applicability, and editorial independence were specified infrequently. Four of the 18 guidelines provided tools to help clinicians apply the recommendations in practice settings; 5 were recommended for use in clinical settings, and the remaining 13 were recommended for use with modification. CONCLUSIONS: Despite the increasing availability of clinical practice guidelines for Procedural Pain in children, the majority are of average quality. More transparency and comprehensive reporting are needed for the guideline development process.
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Mechanisms of sucrose and non-nutritive sucking in Procedural Pain management in infants.
Pain research & management, 2001Co-Authors: Sharyn Gibbins, Bonnie StevensAbstract:The administration of sucrose with and without non-nutritive sucking (NNS) has been examined for relieving Procedural Pain in newborn infants. The calming and Pain-relieving effects of sucrose are thought to be mediated by endogenous opioid pathways activated by sweet taste. The orogustatory effects of sucrose have been demonstrated in animal newborns, and in preterm and full term human infants during Painful procedures. In contrast to sucrose, the analgesic effects of NNS are hypothesized to be activated through nonopioid pathways by stimulation of orotactile and mechanoreceptor mechanisms. Although there is uncertainty as to whether the effects of sucrose and NNS are synergistic or additive, there is sufficient evidence to support the efficacy of combining the two interventions for Procedural Pain relief in infants. In this review article, the underlying mechanisms of sucrose and NNS, separately and in combination for relieving Procedural Pain in preterm and full term infants, are examined. Clinical and research implications are addressed.
Denise Harrison - One of the best experts on this subject based on the ideXlab platform.
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The Psychometric Properties of the MBPS Scale Used to Assess Procedural Pain
The journal of pain : official journal of the American Pain Society, 2018Co-Authors: Dianne J Crellin, Franz E Babl, Nick Santamaria, Denise HarrisonAbstract:Abstract The Modified Behavioral Pain Scale (MBPS) was designed to assess Procedural Pain in infants and is considered valid for assessing immunization Pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 infants and children aged 6 to 42 months undergoing 1 of 4 procedures in the emergency department. Positive correlation between MBPS and Visual Analogue Scale observer applied (VASobs) Pain (r = .74) was shown and inter- and intrarater reliability coefficients were high (.87 and .89, respectively). Construct validity was shown by scale responsiveness to Painful stimuli (4.6 times increase in scores across phases) and the capacity of the scale to distinguish between Painful versus nonPainful procedures (P 3, which was much lower than for children with scores Perspective This article presents the psychometric and practical properties of the MBPS applied to assess Procedural Pain. Identification of a suitable scale for this purpose will support improved Pain management in infants and young children who undergo Painful procedures.
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The Psychometric Properties of the MBPS Scale Used to Assess Procedural Pain.
The journal of pain : official journal of the American Pain Society, 2018Co-Authors: Dianne J Crellin, Franz E Babl, Nick Santamaria, Denise HarrisonAbstract:The Modified Behavioral Pain Scale (MBPS) was designed to assess Procedural Pain in infants and is considered valid for assessing immunization Pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 infants and children aged 6 to 42 months undergoing 1 of 4 procedures in the emergency department. Positive correlation between MBPS and Visual Analogue Scale observer applied (VASobs) Pain (r = .74) was shown and inter- and intrarater reliability coefficients were high (.87 and .89, respectively). Construct validity was shown by scale responsiveness to Painful stimuli (4.6 times increase in scores across phases) and the capacity of the scale to distinguish between Painful versus nonPainful procedures (P < .001). However, mean baseline scores for procedures were not 0 (likely a function of item descriptors for a "0" score) and the mean difference increased across phases for children with baseline scores >3, which was much lower than for children with scores <3 (P = .0001). Finally, 28% of scores changed after the second viewing of a video segment. The MBPS appears reliable and sensitive to Procedural Pain when applied by clinicians. Results question the capacity of the scale to differentiate between Pain- and nonPain-related distress, the feasibility of this scale, and the appropriateness of item descriptors for medical procedures. This article presents the psychometric and practical properties of the MBPS applied to assess Procedural Pain. Identification of a suitable scale for this purpose will support improved Pain management in infants and young children who undergo Painful procedures. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.
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Procedural Pain Scale Evaluation (PROPoSE) study: protocol for an evaluation of the psychometric properties of behavioural Pain scales for the assessment of Procedural Pain in infants and children aged 6-42 months.
BMJ open, 2017Co-Authors: Dianne Crellin, Denise Harrison, Nick Santamaria, Adrian Hutchinson, Tibor Schuster, Franz E BablAbstract:Introduction Infants and children are frequently exposed to Painful medical procedures such as immunisation, blood sampling and intravenous access. Over 40 scales for Pain assessment are available, many designed for neonatal or postoperative Pain. What is not well understood is how well these scales perform when used to assess Procedural Pain in infants and children. Aim The aim of this study was to test the psychometric and practical properties of the Face, Legs, Activity, Cry and Consolability (FLACC) scale, the Modified Behavioural Pain Scale (MBPS) and the Visual Analogue Scale (VAS) observer Pain scale to quantify Procedural Pain intensity in infants and children aged from 6–42 months to determine their suitability for clinical and research purposes. Methods and analysis A prospective observational non-interventional study conducted at a single centre. The psychometric and practical performance of the FLACC scale, MBPS and the VAS observer Pain scale and VAS observer distress scale used to assess children experiencing Procedural Pain will be assessed. Infants and young children aged 6–42 months undergoing one of four Painful and/or distressing procedures were recruited and the procedure digitally video recorded. Clinicians and psychologists will be recruited to independently apply the scales to these video recordings to establish intrarater and inter-rater reliability, convergent validity responsiveness and specificity. Pain score distributions will be presented descriptively; reliability will be assessed using the intraclass correlation coefficient and Bland-Altman plots. Spearman correlations will be used to assess convergence and linear mixed modelling to explore the responsiveness of the scales to Pain and their capacity to distinguish between Pain and distress. Ethics and dissemination Ethical approval was provided by the Royal Children’s Hospital Human Research Ethics Committee, approval number 35220B. The findings of this study will be disseminated via peer-reviewed journals and presented at international conferences.
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Procedural Pain in neonates in Australian hospitals: a survey update of practices.
Journal of paediatrics and child health, 2012Co-Authors: Jann P Foster, Denise Harrison, Kaye Spence, David J Henderson‐smart, Peter H. Gray, John BidewellAbstract:Data were available from 196 (91%) of the 215 eligible hospitals. A CPG informed the management of neonatal Pain in 76 (39%) of thehospitals. There was wide variation in their use between the states, and a significantly higher use of a CPG in higher-level care units. A Painassessment tool was only used in 21 (11%) of the units with greater use in the higher level care neonatal intensive care units (50%) and surgicalneonatal intensive care units (80%). Awareness of breastfeeding for Procedural Pain was reported by 90% of the 196 respondents while 78%reported that it was actually used. Awareness of sucrose for Procedural Pain was lower than breastfeeding at 79%, with 53% reporting that theyused sucrose in their unit. Overall, 89% of the respondents reported that either breastfeeding or sucrose was used for the management ofProcedural Pain in their units.
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Oral Sucrose as an Analgesic Drug for Procedural Pain in Newborn Infants: A Randomised Controlled Trial
2010Co-Authors: Denise HarrisonAbstract:A study was conducted to evaluate the efficacy of oral sucrose as an analgesic drug for Procedural Pain in newborn infants. Results indicated that sucrose should not be used routinely for Procedural Pain in newborn infants without further investigation.
Haixia Gao - One of the best experts on this subject based on the ideXlab platform.
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Efficacy and safety of repeated oral sucrose for repeated Procedural Pain in neonates: A systematic review.
International journal of nursing studies, 2016Co-Authors: Haixia Gao, Honglian Gao, Hua Zhang, Danwen WangAbstract:Abstract Background Although sucrose is most extensively examined for its analgesia effect on a single Procedural Pain, neonates in neonatal intensive care units can be exposed to numerous Painful procedures every day requiring multiple doses of sucrose. Some experiments have been performed to examine the efficacy and safety of repeated sucrose administration for repeated Procedural Pain; however, a systematic review of this topic has not yet been carried out. Objective To identify and assess the evidence demonstrating the efficacy and safety of repeated sucrose for repeated Procedural Pain in neonates. Method A systematic review was conducted using the Cochrane methodology. Pubmed, Cochrane Library, Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CBMdisc, CNKI, VIP, and Wanfang databases were searched through December 2015. All related abstracts were reviewed and the full texts of relevant articles were studied. Randomized controlled trials (RCTs) were included. Risk of bias was assessed for RCTs using quality critical appraisal criteria recommended by Cochrane Handbook. A standardised data form was used to extract information. Results Eight RCTs met our inclusion criteria. Different study designs were used in the included RCTs, which did not allow us to carry out a meta-analysis. The findings from this review indicated that repeated sucrose was effective in reducing both behavioral Pain response and composite Pain scores during repeated Procedural Pain. However, as for physiological Pain response, one trial found less variability in physiological Pain response for term neonates in the sucrose group than the sterile water group, while two trials demonstrated repeated sucrose was inefficacious for preterm neonates. Regarding the clinical outcomes, no study reported adverse effects related to the repeated sucrose administration. Regarding the neurobehavioral development, two trials reported repeated sucrose for repeated Procedural Pain would not lead to poor neurologic development, while one trial reported that preterm infants 10 doses of sucrose per 24h in the first week of life had poorer neurologic development compared with infants who received fewer sucrose doses. What's more, no study reported the long-term neurobehavioral development outcome of neonates who repeatedly received sucrose across repeated Procedural Pain. Conclusion Evidence regarding the efficacy and safety of repeated sucrose across repeated Procedural Pain for neonates is limited. More prospective, multi-centered, large randomized controlled clinical trials with a standardised study design are required before sucrose can be recommended widely as an analgesia for repeated Procedural Pain in neonates.
