新生儿疼痛评估与镇痛管理专家共识（2020版）

doi:10.7499/j.issn.1008-8830.2006181

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摘要

新生儿对疼痛的生物学感知能力与成人相比更加强烈、持久，对疼痛也会存在记忆，而且疼痛带来的各种负面影响可长期存在。因此，规范适宜的疼痛管理，可以减轻或防止疼痛对身体和心理造成的不利影响，加快康复进程。为进一步加深对新生儿疼痛管理的认识，规范新生儿镇痛处置措施，中国医师协会新生儿科医师分会和中国当代儿科杂志编辑委员会基于国内外临床证据，结合临床实践经验，主要从新生儿疼痛的评估及管理疼痛的方法与技术等方面制定本专家共识。推荐阶梯式新生儿镇痛管理，其中，对于轻度疼痛刺激，温柔抚触及非营养吸吮联合蔗糖水喂养是有效缓解方式；对于中度疼痛，选用合适套管针、精准穿刺是减少疼痛的重要前提，另外，穿刺部位应用局麻类药物亦有良好效果；对于重度疼痛，往往需应用静脉镇静药物，但目前证据尚不一致。

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关键词 ：疼痛, 评估, 镇痛管理, 专家共识, 新生儿

Abstract：Compared with adults, neonates tend to have stronger and more persistent biological perception of pain. They may have the memory for pain and the negative effects caused by pain may exist for a long time. Therefore, standardized pain management can reduce or prevent the adverse effect of pain on body and mind and promote the rehabilitation process. In order to further deepen the understanding of pain management and standardize the analgesic measures for neonates, the Neonatologist Branch of Chinese Medical Association and Editorial Board of Chinese Journal of Contemporary Pediatrics have developed an expert consensus based on the clinical evidence in China and overseas and with reference to clinical experience from the following aspects:evaluation of neonatal pain and methods and techniques of pain management. It is recommended to adopt a step-by-step analgesic management for neonates. For mild pain stimulation, it is effective to relieve the pain by gentle touch and non-nutritive sucking combined with sucrose feeding. For moderate pain, selection of appropriate trocar needle and skilled puncture are important to reduce the pain, and in addition, the application of local anesthetics at the site of puncture also has a good effect. For severe pain, intravenous sedative drugs are often required, but no consistent evidence has been obtained so far.

Key words： Pain Assessment Analgesia management Expert consensus Neonate

收稿日期: 2020-06-27

通讯作者: 封志纯,男,教授,解放军总医院第七医学中心附属八一儿童医院NICU,Email:zhjfengzc@126.com。 E-mail: zhjfengzc@126.com

引用本文:

中国医师协会新生儿科医师分会,中国当代儿科杂志编辑委员会. 新生儿疼痛评估与镇痛管理专家共识（2020版）[J]. 中国当代儿科杂志, 2020, 22(9): 923-930.

Neonatology Branch of Chinese Medical Association,Editorial Board of Chinese Journal of Contemporary Pediatrics. Expert consensus on neonatal pain assessment and analgesia management (2020 edition)[J]. CJCP, 2020, 22(9): 923-930.

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