Intervenções Não-Farmacológicas e seu efeito nas Respostas Indicadoras de Dor em Bebês rematuros submetidos a Procedimentos de Coleta de Sangue

Abstract

The neonatal pain is present in the Neonatal Intensive Care Unit – NICU, in the term as well as in the pre-term babies. Even though health professionals have the knowledge that the newborn feels pain, most of them don’t know how to identify its occurrence and mainly, don’t know how to prevent it during the routine procedures of blood withdraw. The objective of the present study was to identify responses indicative of pain in premature babies during procedures of blood withdraw carried on in the NICU. Five premature neonates participated of the study. The observations of the responses indicative of pain were done in the NICU setting with application of the Neonatal Facial Code System – NFCS and the Neonatal Infant Pain Scale – NIPS. Physiological measures were also taken: Heart Rate (HR) and Oxygen Saturation (SatO2) two minutes before, during the blood withdraw and two minutes after the procedure. Experimental Control was obtained using a Reversal Design of the ABA type for three of the five participants. A multiple Elements Design combined with a Reversal Design was used with two participants. The proposed interventions for the reduction of pain responses were the Administration of Glucose, Non-nutritive Suction, and Manual Contention. The observations registered in the NIPS and NFCS scales suggest the presence of pain during the routine procedure of blood withdraw as well as its reduction with the non-pharmacological interventions proposed. The analysis of the physiological measures of pain revealed that both the Heart Rate as well as the Oxygen Saturation did not show a direct relation with the observations of pain in the premature baby. These measures did not present clinical relevance for all variations were considered normal physiological responses. It can be concluded that all the non-pharmacological interventions tested were effective in reducing the responses indicative of pain in the premature baby.