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You searched for:"Eduardo Carlos Tavares"
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Rev Bras Ter Intensiva. 2011;23(2):228-237
DOI 10.1590/S0103-507X2011000200017
This article aims to review the main studies evaluating glucose as a therapeutic alternative during mildly to moderately painful procedures in neonatology, highlighting its benefits and limitations. During their stay in neonatal intensive care units, neonates are constantly subjected to a number of painful procedures without proper therapeutic management, although the medical literature emphatically recommends this type of management, highlighting the deleterious neurological consequences of pain. Most of these interventions are frequently necessary in neonatal intensive care units to maintain clinical stability in these children; the use of systemic analgesia, however, is not considered to be a good option. The administration of oral glucose solution is apparently effective and safe for pain control during procedures causing mild-to-moderate pain in neonate intensive care units, with rare adverse effects; however, its mode of action has not yet been described clearly in the literature. The administration of oral glucose solution is well described for use in venous punctures; it is apparently effective also for heel punctures, especially when associated with nonnutritive sucking, with most studies showing favorable results.
Abstract
Rev Bras Ter Intensiva. 2011;23(2):228-237
DOI 10.1590/S0103-507X2011000200017
This article aims to review the main studies evaluating glucose as a therapeutic alternative during mildly to moderately painful procedures in neonatology, highlighting its benefits and limitations. During their stay in neonatal intensive care units, neonates are constantly subjected to a number of painful procedures without proper therapeutic management, although the medical literature emphatically recommends this type of management, highlighting the deleterious neurological consequences of pain. Most of these interventions are frequently necessary in neonatal intensive care units to maintain clinical stability in these children; the use of systemic analgesia, however, is not considered to be a good option. The administration of oral glucose solution is apparently effective and safe for pain control during procedures causing mild-to-moderate pain in neonate intensive care units, with rare adverse effects; however, its mode of action has not yet been described clearly in the literature. The administration of oral glucose solution is well described for use in venous punctures; it is apparently effective also for heel punctures, especially when associated with nonnutritive sucking, with most studies showing favorable results.
Abstract
Rev Bras Ter Intensiva. 2010;22(1):69-76
DOI 10.1590/S0103-507X2010000100012
Premature neonates are customarily submitted to invasive painful procedures during their stay in NICUs that are necessary to maintain their clinically stability. Topical anesthesia is a good option to be considered in the treatment of interventions that lead to mild to moderate pain and has the advantage of no systemic effects. In Brazil the most known topical anesthetic available for use is the eutectic mixture of local anesthetics (EMLA® cream). Its efficacy in the treatment of cutaneous painful procedures is well established for children and adults. Its utilization in neonates has been investigated also due to the risk to develop methemoglobinemia. The procedures in which topical anesthesia would be well indicated are those related to mild to moderate pain like: arterial and venous punction, hell lance puncture, lumbar puncture and percutaneous central catheter installation. The studies in the literature have so far lead to different conclusions, mainly depending on the type of the procedure and also due to the use of very different methodologies. The possibility of a direct pain evaluation may decrease the methodological bias leading to a more accurate evaluation of the efficacy of the topical anesthesia and also allowing comparisons among the indirect pain measures used so far.
Abstract
Rev Bras Ter Intensiva. 2010;22(1):69-76
DOI 10.1590/S0103-507X2010000100012
Premature neonates are customarily submitted to invasive painful procedures during their stay in NICUs that are necessary to maintain their clinically stability. Topical anesthesia is a good option to be considered in the treatment of interventions that lead to mild to moderate pain and has the advantage of no systemic effects. In Brazil the most known topical anesthetic available for use is the eutectic mixture of local anesthetics (EMLA® cream). Its efficacy in the treatment of cutaneous painful procedures is well established for children and adults. Its utilization in neonates has been investigated also due to the risk to develop methemoglobinemia. The procedures in which topical anesthesia would be well indicated are those related to mild to moderate pain like: arterial and venous punction, hell lance puncture, lumbar puncture and percutaneous central catheter installation. The studies in the literature have so far lead to different conclusions, mainly depending on the type of the procedure and also due to the use of very different methodologies. The possibility of a direct pain evaluation may decrease the methodological bias leading to a more accurate evaluation of the efficacy of the topical anesthesia and also allowing comparisons among the indirect pain measures used so far.
