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Umsetzung von Evidenz – Schmerztherapie bei Neugeborenen, Säuglingen und Kleinkindern während Nadelstichverfahren

Deutsche Fassung

Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures

German version

  • Pain Clinical Updates
  • Published:
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Zusammenfassung

Einleitung

Die Schmerztherapie bei frühgeborenen, kranken und gesunden Neugeborenen, Säuglingen und Kleinkindern (bis zu einem Alter von 2 Jahren) ist gemäß übereinstimmenden Berichten mangelhaft. Wirksame Strategien werden schlecht umgesetzt.

Zielsetzung

In diesem Beitrag soll die vorliegende Evidenz zu wirksamen schmerztherapeutischen Strategien während mit Nadelstich verbundener Verfahren zusammengefasst werden. Zudem sollen Initiativen vorgestellt werden, die sich auf die Umsetzung der Evidenz in die Praxis konzentrieren.

Methoden

Ein Schwerpunkt dieses klinischen Updates liegt auf der Kampagne Global Year for Translating Pain Knowledge to Practice der International Association for the Study of Pain von 2022 mit Blick auf die spezielle Patientengruppe der Neugeborenen, Säuglinge und Kleinkinder. Es wird die beste Evidenz zusammengefasst. Existierende Strategien für den Wissenstransfer sowie verfügbare Programme für die Umsetzung von Evidenz in die Praxis werden vorgestellt

Ergebnisse

Zu den wirksamen Strategien für Neugeborene und junge Säuglinge während häufig durchgeführter Nadelstichverfahren zählen kleine Volumina süßer Lösungen, Stillen oder Haut-zu-Haut-Kontakt, soweit durchführbar und kulturell akzeptiert. Darüber hinaus können Ansätze wie nichtnutritives Saugen, Positionierung, Einwickeln („swaddling“), sanfte Berührungen, Halten in Froschstellung („facilitated tucking“) und sicheres Halten angewendet werden. In Bezug auf Kleinkinder ist die Evidenz schwächer, zudem ist die Unterscheidung zwischen Schmerz und Stress eine Herausforderung. Zu den empfohlenen Strategien bei Nadelstichverfahren zählen jedoch ein Halten in aufrechter, sicherer und behaglicher Position durch einen Elternteil/Betreuer, altersgerechte Ablenkung und topische Anästhetika. Die Umsetzung einer effektiven Schmerzbehandlung muss die Familie einschließen; diese muss darin unterstützt und bestärkt werden, ihr Kind während schmerzhafter Verfahren zu beruhigen und zu trösten. Es gibt organisationsbezogene, nationale und weltweite Initiativen zur Verbesserung der Implementierung wirksamer Schmerztherapien.

Schlussfolgerung

Es gibt Evidenz für wirksame Strategien der Schmerzbehandlung von Neugeborenen, Säuglingen und Kleinkindern. Große Anstrengungen werden unternommen, um das vorhandene Wissen in die Praxis umzusetzen.

Abstract

Introduction

Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented.

Objectives

To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice.

Methods

This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented.

Results

Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needlerelated procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist.

Conclusion

There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.

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Author information

Authors and Affiliations

  1. Department of Nursing, The University of Melbourne, Grattan St, Parkville, 3010, Melbourne, Victoria, Australien

    Denise Harrison

  2. School of Nursing, The University of Ottawa, Ottawa, Ontario, Kanada

    Denise Harrison

  3. Murdoch Children’s Research Institute, Melbourne, Victoria, Australien

    Denise Harrison

  4. Royal Children’s Hospital, Melbourne, Victoria, Australien

    Denise Harrison

  5. The Hospital for Sick Children, Toronto, Ontario, Kanada

    Mariana Bueno

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  1. Denise Harrison
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  2. Mariana Bueno
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Correspondence to Denise Harrison.

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D. Harrison und M. Bueno geben an, dass kein Interessenkonflikt besteht.

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Deutsche Fassung von: Harrison D, Bueno M (2023) Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures. Pain Clinical Updates in Pain Reports. PR9 8 (2023) e1064. https://doi.org/10.1097/PR9.0000000000001064. Publikation auf Deutsch mit Genehmigung der International Association for the Study of Pain und der Autoren. Verantwortlich: Frau Prof. Dr. C. Sommer, Würzburg

Aus Gründen der besseren Lesbarkeit wird in dieser Übersetzung das generische Maskulinum verwendet. Sämtliche Personenbezeichnungen gelten für alle Geschlechter.

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Harrison, D., Bueno, M. Umsetzung von Evidenz – Schmerztherapie bei Neugeborenen, Säuglingen und Kleinkindern während Nadelstichverfahren. Schmerz (2024). https://doi.org/10.1007/s00482-024-00797-y

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