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Der Schmerz

, Volume 32, Issue 2, pp 153–164 | Cite as

Schmerztherapie bei Früh- und Neugeborenen

  • M. Richter
  • B. Seipolt
CME
  • 474 Downloads

Zusammenfassung

Auf der neonatologischen Intensivstation (NICU) ist Schmerz ein zentrales Thema. Akute wie anhaltende (kontinuierliche, chronische) Schmerzen sind häufig. Da validierte Biomarker oder physiologische Schmerzmessinstrumente, wie Speichelkortisol, Hautwiderstand oder Herzfrequenzvariabilität, bisher fehlen, kann Schmerz in der Neonatologie aktuell nur über die Fremdbeobachtung eingeschätzt werden. Dies erfolgt durch eine regelmäßige, standardisierte Nutzung von Schmerzskalen (Scores). Schmerz und Medikamente (Analgetika/Sedativa) können sich in dieser vulnerablen Zeit negativ auf die Hirnentwicklung auswirken. Daher stehen die Reduktion der Anzahl an Schmerzreizen und der medikamentöse Leitsatz „So viel wie nötig, so wenig wie möglich“ im Vordergrund. Bei anhaltendem (kontinuierlichem, chronischem) Schmerz sind die Reduktion der Analgetika und Sedativa sowie die Vermeidung von Entzugserscheinungen weitere Herausforderungen.

Schlüsselwörter

Intensivmedizin Schmerzmessung Opioidanalgetika Benzodiazepine Entzugssyndrom 

Pain therapy for premature babies and neonates

Abstract

Pain is a central topic on neonatal intensive care units (NICU). Acute as well as prolonged (continuous and chronic) pain frequently occurs. Due to a lack of validated physiological measurement instruments for pain (e. g. saliva cortisol, skin conductance and heart rate variability) pain in neonatology can only be assessed by external observation through the bedside team with pain scores using a regular, standardized procedure. During this very vulnerable period pain and medications (analgesics/sedatives) can negatively influence the brain development of premature babies and neonates. Therefore, limitation of the number of pain stimuli and the medicinal guideline “as much as necessary but as little as possible” are eminently important. When dealing with prolonged (continuous and chronic) pain, further challenges are a reduction of analgesics and sedatives as well as avoidance of withdrawal symptoms.

Keywords

Intensive care (NICU) Pain measurement Analgesics, opioid Benzodiazepines Substance withdrawal syndrome 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Richter und B. Seipolt geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Deutsche Schmerzgesellschaft e.V. Published by Springer Medizin Verlag GmbH, ein Teil von Springer Nature - all rights reserved 2018

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Kinder- und JugendmedizinUniversitätsklinikum Carl Gustav CarusDresdenDeutschland

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