Evaluation of pain of neonates during invasive procedures in intensive care

Cruz, Cibele Thomé da; Gomes, Joseila Sonego; Kirchner, Rosane Maria; Stumm, Eniva Miladi Fernandes

doi:10.5935/1806-0013.20160070

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ORIGINAL ARTICLES • Rev. dor 17 (3) • Jul-Sep 2016 • https://doi.org/10.5935/1806-0013.20160070 copy

Evaluation of pain of neonates during invasive procedures in intensive care

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Neonates do not verbalize pain, so it is up to health professionals involved with their assistance to be qualified to evaluate pain during invasive procedures to plan relief strategies. This study aimed at evaluating pain in neonates admitted to a neonatal intensive care unit during invasive procedures.

METHODS:

Crossover investigation with 34 neonates admitted to the intensive care unit of a general hospital, from December/2012 to February/2013. Data were collected with the Neonatal Infant Pain Scale and analyzed by descriptive statistics.

RESULTS:

Procedures triggering more pain were tracheal tube aspiration, airways and venous puncture. Babies had severe pain during tracheal intubation and passage of peripheral insertion central catheter.

CONCLUSION:

Evaluating pain as the fifth vital sign with validated scale during invasive procedures is critical for planning and implementing ethic and humanized nursing assistance.

Keywords:
Intensive care unit; Neonate; Pain measurement

Parameters	0 point	1 point	2 points
Facial expression	Relaxed	Contracted	–
Cry	Absent	Mumbling	Vigorous
Breathing	Relaxed	Different than basal	–
Arms	Relaxed	Flexed/ stretched	–
Legs	Relaxed	Flexed/ stretched	–
Alertness	Sleeping/ calm	Uncomfortable	–

Age	Procedures	Mild pain n(%)	Moderate pain n(%)	Severe pain n(%)	Total n(%)
Preterm	TT or AW aspiration	1(4.4)	9(39.1)	13(56.5)	23(100)
NN	Venous puncture	-	6(28.5)	15(71.4)	21(100)
	Peripheral capillary glycemia test	3(15.8)	7(36.84)	9(47)	19(100)
	Intubation	-	1(50)	1(50)	2(100)
	Orogastric probe	-	1(11.1)	8(88.8)	9(100)
	PICC insertion	-	1(100)	-	1(100)
Term NN	TT or AW aspiration	3(30)	6(60)	1(10)	10(100)
	Venous puncture	-	2(50)	2(50)	4(100)
	Peripheral capillary glycemia test	-	2(66.6)	1(33.3)	3(100)
	Intubation	-	-	1(100)	1(100)

	Procedures	Mild pain n(%)	Moderate pain n(%)	Severe pain n(%)	Total n(%)
Female	TT or AW aspiration	4(21)	11(58)	4(21)	19(100)
	Venous puncture	-	5(45.4)	6(54.5)	11(100)
	Peripheral capillary glycemia test	1(8.3)	7(58.3)	4(33.3)	12(100)
	Intubation	-	-	2(100)	2(100)
	Orogastric probe	-	-	2(100)	2(100)
Male	TT or AW aspiration	-	4(28.6)	10(71.4)	14(100)
	Venous puncture	-	3(21.4)	11(78.6)	14(100)
	Peripheral capillary glycemia test	2(22.2)	2(22.2)	5(55.5)	9(100)
	Intubation	-	1(100)	-	1(100)
	Orogastric probe	-	1(50)	1(50)	2(100)
	PICC insertion	-	1(100)	-	1(100)

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[1] Correspondence to: Cibele Thomé da Cruz, Rua Siqueira Couto, 1665 - Bairro Burtet, 98700-000 Ijuí, RS, Brasil. E-mail: cibelethome@bol.com.br