採非藥物措施減輕早產兒視網膜病變篩檢所致之疼痛

Non-Pharmacological Interventions in Reducing the Pain of Screening for Retinopathy of Prematurity

早產兒視網膜病變（retinopathy of prematurlty， ROP）篩檢是未滿32週之早產兒住院期間常須執行的檢查，篩檢過程會帶給早產兒中度至重度的疼痛與不適，因此，過去已有許多研究探討如何減輕醫療處置引起之疼痛，疼痛管理亦逐漸由單一藥物止痛延伸至以非藥物措施輔助而目前針對早產兒進行ROP篩檢輔以非藥物措施減痛之成效仍缺乏統整性文獻，故本研究目的為整合相同主題的實驗性研究進行系統性文獻回顧，以統整非藥物措施減輕早產兒ROP篩檢所致疼痛之實證。搜尋1996年至2016年12月前發表的中英文文獻，進入五個資料庫如華藝線上圖書館、The Cochrane Library、PubMed、Medline、ProQuest中搜尋，最後共得9篇實驗性研究。研究結果發現，給予蔗糖搭配奶嘴、葡萄糖、母奶及多感官刺激對早產兒ROP篩檢時具減痛成效，而對其他生理指標，如生命徵象、血氧濃度及哭泣時間等則未有助益。本研究結果期提供早產兒臨床實務之照護參考。

Retinopathy of prematurity (ROP) screening is recommended in preterm infants with a gestational age of less than 32 weeks during their hospital stay. Screening examinations causes moderate to severe pain and discomfort in preterm infants. Thus, many previous studies were to explore how to reduce the pain associated with ROP screening. Recently, pain management during ROP screening by single analgesic administration extend to combine with non-pharmacological interventions and currently still lacked of systematic review in this field. The aim of the study was to conduct a systematic review to summarize the effectiveness of non-pharmacological interventions in reducing pain during ROP screening in preterm infants. This review focused on studies published between 1996 and 2016, Dec, and the following databases were searched: Airiti Library, The Cochrane Library, PubMed, MEDLINE, and ProQuest. Nine experimental studies met the inclusion criteria and were selected for further analysis. The results showed that oral sucrose with pacifier, glucose, expressed breast milk, and multi-sensory stimulation were effective measures for pain relief during screening for ROP, but there were no benefits to vital signs, O2 saturation and crying time. These results can be used as a reference for reducing pain during ROP screening of preterm infants for clinical practice.