Melo, Gleicia Martins de; Cardoso, Maria Vera Lúcia Moreira Leitão

doi:10.1590/0034-7167-2016-0003

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Revista Brasileira de Enfermagem

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Sumário

RESEARCH • Rev. Bras. Enferm. 70 (2) • Mar-Apr 2017 • https://doi.org/10.1590/0034-7167-2016-0003 copiar

Medidas no farmacológicas en recién nacidos prematuros sometidos a la punción arterial

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

evaluar el dolor en recién nacidos prematuros y comparar las variables neonatales y terapéuticas con las puntuaciones totales del Neonatal Facial Coding System de los recién nacidos prematuros sometidos a una punción arterial expuestos a la música y glucosa al 25% por vía oral.

Método:

estudio comparativo con 48 fi lmaciones de los recién nacidos prematuros divididos en el Grupo 1 - música (26) y el Grupo 2 - glucosa al 25% (22). Las fi lmaciones fueron analizadas individualmente por tres enfermeras capacitadas después de coefi ciente Kappa de al menos 80%.

Resultados:

las variables y puntuaciones de dolor de los grupos no fueron estadísticamente signifi cativas (p<0,05) de acuerdo con el Neonatal Facial Coding System. En el Grupo 1, 80,8% de los recién nacidos prematuros mostraron mayores cantidades de puntuaciones ≥ 3 en las variables neonatales (sexo, tipo de parto) y las variables terapéuticas (tipo de la terapia de oxígeno, lugar de internación, tipo de punción).

Conclusión:

No hubo diferencias cuando se comparan los grupos de música y de glucosa al 25% y las variables estudiadas.

Descriptores:
Recién Nacido; Dolor; Música, Glucosa; Enfermería Neonatal

Intervention	Variables	NFCS Pain Score^* * NFCS = Neonatal Facial Coding System;				Total		p^† † p = Pearson's Chi-square test or Fischer's exact test;
		< 3		≥ 3		Total
		n^‡ ‡ N = Number of newborn;	%	n	%	n	%
	Gender
Group 1^§ § Group 1 = Music; \|\|Group 2 = 25% Glucose.	Male	2	12.5	14	87.5	16	61.5
	Female	3	30.0	7	70.0	10	38.5	0.271
	Total	5	19.2	21	80.8	26	100.0
Group 2^\|\| \|\| Group 2 = 25% Glucose.	Male	10	66.7	5	33.3	15	68.2
	Female	2	28.6	5	71.4	7	31.8	0.095
	Total	12	54.5	10	45.5	22	100.0
	Type of delivery
Group 1	Normal	0	0.0	4	100.0	4	15.4
	Cesarean	4	21.1	15	78.9	19	73.1	0.502
	Forceps	1	33.3	2	66.7	3	11.5
	Total	5	19.2	21	80.8	26	100.0
Group 2	Normal	2	40.0	3	60.0	5	22.7
	Cesarean	10	58.8	7	41.2	17	77.3	0.457
	Forceps	0	0.0	0	0.0	0	0.0
	Total	12	54.5	10	45.5	22	100.0

Variables	NFCS Value^* * NFCS = Neonatal Facial Coding System;	Mean±DP^† † SD = standard deviation;	IC^‡ ‡ CI = Confidence Interval; 95%		Minimum	Maximum	p^§ § p = Student's t test or Mann-Whitney U test
Variables	NFCS Value^* * NFCS = Neonatal Facial Coding System;	Mean±DP^† † SD = standard deviation;	Inferior Limit	Superior Limit	Minimum	Maximum	p^§ § p = Student's t test or Mann-Whitney U test
Weight at delivery	< 3	2146.0±564.7	1444.8	2847.2	1336.0	2682.0
	≥ 3	2133.7±654.4	1835.8	2431.6	1226.0	3946.0	0.970
	Total	2136.1±627.4	1882.7	2389.5	1226.0	3946.0
Cephalic perimeter	< 3	31.9±2.0	29.4	34.4	29.5	34.0
	≥ 3	31.2±2.6	30.0	32.4	26.5	36.5	0.569
	Total	31.3±2.4	30.3	32.3	26.5	36.5
Thoracic perimeter	< 3	28.4±3.4	24.1	32.7	23.0	31.0
	≥ 3	27.9±3.1	26.5	29.3	22.0	34.5	0.742
	Total	28.0±3.1	26.7	29.2	22.0	34.5
Number of punctures	< 3	1.0±0.0	1.0	1.0	1.0	1.0
	≥ 3	1.2±0.7	0.9	1.6	1.0	4.0	0.461
	Total	1.2±0.6	0.9	1.4	1.0	4.0
Apgar 1st minute	< 3	8.0±0.0	8.0	8.0	8.0	8.0
	≥ 3	6.5±2.1	5.6	7.5	2.0	9.0	0.133
	Total	6.8±2.0	6.0	7.6	2.0	9.0
Apgar 5th minute	< 3	8.8±0.4	8.2	9.4	8.0	9.0
	≥ 3	8.4±0.9	8.0	8.8	6.0	10.0	0.309
	Total	8.5±0.8	8.1	8.8	6.0	10.0
Corrected gestational age (weeks)	< 3	34.8±1.7	32.8	36.9	32.6	36.3
	≥ 3	34.2±1.6	33.5	35.0	32.0	36.5	0.463
	Total	34.4±1.6	33.7	35.0	32.0	36.5
Corrected gestational age (days)	< 3	245.2±11.1	231.4	259.0	230.0	255.0
	≥ 3	241.3±10.9	236.4	246.3	224.0	257.0	0.483
	Total	242.1±10.8	237.7	246.4	224.0	257.0
Chronological age (days)	< 3	1.2±1.8	-1.0	3.4	0.0	4.0
	≥ 3	2.1±5.4	-0.3	4.6	0.0	23.0	0.705
	Total	2.0±4.9	0.0	3.9	0.0	23.0

Variables	NFCS Value^* * NFCS = Neonatal Facial Coding System;	Mean±DP^† † SD = standard deviation;	IC^‡ ‡ CI = Confidence Interval; 95%		Minimum	Maximum	p^§ § p = Student's t test or Mann-Whitney U test
Variables	NFCS Value^* * NFCS = Neonatal Facial Coding System;	Mean±DP^† † SD = standard deviation;	Inferior Limit Superior Limit		Minimum	Maximum	p^§ § p = Student's t test or Mann-Whitney U test
Weight at delivery	<3	1,882.0±536.3	1,541.3	2,222.7	918.0	2,999.0
	≥ 3	1,853.3±445.7	1,534.5	2,172.1	1350.0	2,578.0	0.894
	Total	1,869.0±485.8	1,653.6	2,084.3	918.0	2,999.0
Cephalic perimeter	< 3	29.3±3.8	26.9	31.7	20.0	35.5
	≥ 3	30.2±1.7	29.0	31.3	28.0	32.6	0.530
	Total	29.7±3.0	28.4	31.0	20.0	35.5
Thoracic perimeter	< 3	26.9±3.6	24.6	29.2	20.0	32.0
	≥ 3	27.9±3.2	25.6	30.1	23.0	34.0	0.529
	Total	27.3±3.4	25.9	28.8	20.0	34.0
Number of punctures	< 3	1.0±0.0	1.0	1.0	1.0	1.0
	≥ 3	1.2±0.4	0.9	1.5	1.0	2.0	0.114
	Total	1.1±0.3	1.0	1.2	1.0	2.0
Apgar 1st minute	< 3	6.6±1.5	5.6	7.5	4.0	9.0
	≥ 3	6.1±2.8	4.1	8.1	2.0	9.0	0.615
	Total	6.4±2.2	5.4	7.3	2.0	9.0
Apgar 5th minute	< 3	8.3±0.7	7.9	8.7	7.0	9.0
	≥ 3	8.2±1.0	7.5	8.9	7.0	9.0	0.716
	Total	8.3±0.8	7.9	8.6	7.0	9.0
Corrected gestational age (weeks)	< 3	33.4±1.8	32.3	34.5	32.0	36.6
	≥ 3	34.2±1.6	33.1	35.3	32.4	36.6	0.274
	Total	33.8±1.7	33.0	34.5	32.0	36.6
Corrected gestational age (days)	< 3	234.5±12.8	226.4	242.6	224.0	258.0
	≥ 3	240.4±11.6	233.1	248.7	228.0	258.0	0.275
	Total	237.2±12.3	231.7	242.7	224.0	258.0
Chronological age (days)	< 3	4.3±11.5	-3.0	11.5	0.0	40.0
	≥ 3	1.7±2.4	0.0	3.4	0.0	8.0	0.499
	Total	3.1±8.5	-0.7	6.9	0.0	40.0

Intervention	Variables	NFCS Pain Score^* * NFCS = Neonatal Facial Coding System;				Total		p^† † p = Pearson's Chi-square test or Fischer's exact test;
		< 3		≥ 3
		n^‡ ‡ N = Number of newborn;	%	n	%	n	%
	Type of oxygen therapy
Group 1^§ § Group 1 = Music;	Mechanical ventilation	1	16.7	5	83.3	6	23.1
	Continuous Positive Airway Pressure	2	20.0	8	80.0	10	38.5
	Oxi-Hood	2	28.6	5	71.4	7	26.9	0.888
	Ambient air	0	0.0	3	100.0	3	11.5
	Total	5	19.2	21	80.8	26	100.0
Group 2^\|\| \|\| Group 2 = 25% Glucose	Mechanical ventilation	3	75.0	1	25.0	4	18.2
	Continuous Positive Airway Pressure	4	50.0	4	50.0	8	36.4
	Oxi-Hood	4	66.7	2	33.3	6	27.2	0.474
	Ambient air	1	25.0	3	75.0	4	18.2
	Total	12	54.5	10	45.5	22	100.0
	Admission location
Group 1	High risk	4	16.7	20	83.3	24	100.0
	Medium risk	1	50.0	1	50.0	2	8.3	0.250
	Total	5	19.2	21	80.8	26	108.3
Group 2	High risk	10	58.8	7	41.2	17	77.3
	Medium risk	2	40.0	3	60.0	5	22.7	0.406
	Total	12	54.5	10	45.5	22	100.0
	Puncture location
Group 1	Right radial	2	16.7	10	83.3	12	46.2
	Left radial	3	25.0	9	75.0	12	46.2
	Right brachial	0	0.0	1	100.0	1	3.8	0.853
	Left brachial	0	0.0	1	100.0	1	3.8
	Total	5	19.2	21	80.8	26	100.0
Group 2	Right radial	6	50.0	6	50.0	12	54.5
	Left radial	5	55.6	4	44.4	9	41.0
	Right brachial	0	0.0	0	0.0	0	0.0	0.626
	Left brachial	1	100.0	0	0.0	1	4.5
	Total	12	54.5	10	45.5	22	100.0

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[1] CORRESPONDING AUTHOR: Maria Vera Lúcia Moreira Leitão Cardoso. E-mail: cardoso@ufc.br