Epidemiology and neonatal pain management of heelsticks in intensive care units: EPIPPAIN 2, a prospective observational study

Autor: Luc Desfrere, Zied Merchaoui, Gaelle Vottier, Sergio Eleni, Kanwaljeet J. S. Anand, Sylvain Renolleau, Stéphanie Droutman, Djamel Mellah, Valérie Biran, Xavier Durrmeyer, Emilie Courtois, Ricardo Carbajal, Dominique Brault, Pascal Bolot, Florence Castela, A Coursol, Camille Roussel, Nicolas Boimond, Patricia Cimerman, Jean-François Magny, Hélène Chappuy
Rok vydání: 2016
Předmět:
Zdroj: International Journal of Nursing Studies. 59:79-88
ISSN: 0020-7489
Popis: Background Heelstick is the most frequently performed skin-breaking procedure in the neonatal intensive care units (NICUs). There are no large multicenter studies describing the frequency and analgesic approaches used for heelsticks performed in NICUs. Objectives To describe the frequency of heelsticks and their analgesic management in newborns in the NICU. To determine the factors associated with the lack of specific preprocedural analgesia for this procedure. Design EPIPPAIN 2 (Epidemiology of Procedural PAin In Neonates) is a descriptive prospective epidemiologic study. Setting All 16 NICUs in the Paris region in France. Participants All newborns in the NICU with a maximum corrected age of 44 weeks +6 days of gestation on admission who had at least one heelstick during the study period were eligible for the study. The study included 562 newborns. Methods Data on all heelsticks and their corresponding analgesic therapies were prospectively collected. The inclusion period lasted six weeks, from June 2, 2011 to July 12, 2011. Newborns were followed from their admission to the 14th day of their NICU stay or discharge, whichever occurred first. Results The mean (SD) gestational age was 33.3 (4.4) weeks and duration of participation was 7.5 (4.4) days. The mean (SD; range) of heelsticks per neonate was 16.0 (14.4; 1–86) during the study period. Of the 8995 heelsticks studied, 2379 (26.4%) were performed with continuous analgesia, 5236 (58.2%) with specific preprocedural analgesia. Overall, 6764 (75.2%) heelsticks were performed with analgesia (continuous and/or specific). In a multivariate model, the increased lack of preprocedural analgesia was associated with female sex, term birth, high illness severity, tracheal or noninvasive ventilation, parental absence and use of continuous sedation/analgesia. Conclusions Heelstick was very frequently performed in NICUs. Although, most heelsticks were performed with analgesia, this was not systematic. The high frequency of this procedure and the known adverse effects of repetitive pain in neonates should encourage the search of safe and effective strategies to reduce their number.
Databáze: OpenAIRE
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