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Schmerztherapie auf der (neonatologischen) Intensivstation

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Schmerztherapie bei Kindern
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Zusammenfassung

Wann beim menschlichen Fetus die Schmerzempfindung einsetzt und wie überhaupt Schmerz von ihm empfunden wird, ist bis heute nicht endgültig geklärt [79]. Korrekterweise sollte man besser über Nozizeption als über Schmerzempfindung sprechen: „Schmerz“ ist definitionsgemäß mit dem Erleben starker Emotionen verbunden [4]; solche werden einem Fetus üblicherweise nicht zugestanden. Auf die feinsinnige Unterscheidung zwischen Nozizeption und Schmerzempfindung [4] wollen wir — wie in der einschlägigen Literatur durchaus üblich — in diesem Beitrag jedoch verzichten.

Der Autor wird unterstützt durch die Peter und Ruth Wirts-Stiftung, Schweiz.

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Literatur

  1. Acharya AB, Bustani PC, Phillips JD, Taub NA, Beattle RM (1998) Randomised controlled trial of eutectic mixture of local anaesthetics cream for venepuncture in healthy preterm infants. Arch Dis Child Fetal Neonatal Ed 78: F138–142

    Article  PubMed  CAS  Google Scholar 

  2. American Academy of Pediatrics, Canadian Paediatric Society (2000) Prevention and management of pain and stress in the neonate. Pediatrics 105: 454–461

    Article  Google Scholar 

  3. Anand KJ (2000) Effects of perinatal pain and stress. Prog Brain Res 122: 117–129

    Article  PubMed  CAS  Google Scholar 

  4. Anand KJS, Hickey PR (1987) Pain and its effects in the human neonate and fetus. N Engl J Med 817: 1321–1329

    Article  Google Scholar 

  5. Anand KJS, Hickey PR (1992) Halothane-mor-phine compared with high-dose sufentanil for anesthesia and postoperative analgesia in neonatal cardiac surgery. N Engl J Med 326: 1–9

    Article  PubMed  CAS  Google Scholar 

  6. Anand KJS, International Evidence-Based Group for Neonatal Pain (2001) Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med 155: 173–180

    PubMed  CAS  Google Scholar 

  7. Anand KJS, Mcintosh N, Lagercrantz H, Pelausa E, Young TE, Vasa R (1999) Analgesia and sedation in preterm neonates who require ventilatory support. Arch Pediatr Adolesc Med 153: 331–338

    Article  PubMed  CAS  Google Scholar 

  8. Anand KJS, Sippell WG, Aynsley-Green A (1987) Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response. Lancet (1)8524: 62–66

    Article  PubMed  CAS  Google Scholar 

  9. Andrews K, Fitzgerald M (1997) Biological barriers to paediatric pain management. Clin J Pain 13: 138–143

    Article  PubMed  CAS  Google Scholar 

  10. Bauer K, Versmold H (1999) Analgesie bei Früh- und Neugeborenen. Pädiatr Prax 57: 169–78

    Google Scholar 

  11. Baumgartner R, Fauchère JC, Bucher HU (2000) Künstliche Süß stoffe reduzieren die Schmerzreaktion beim Guthrie-Test. Z Geburtsh Neonatol 204: S1

    Article  Google Scholar 

  12. Barr RG (1998) Reflections on measuring pain in infants: dissociation in responsive systems and „honest signalling“. Arch Dis Child Fetal Neonatal Ed 79: F152–156

    Article  PubMed  CAS  Google Scholar 

  13. Bellieni CV, Buonocore G, Nenci A, Franci N, Cordelli DM, Bagnoli F (2001) Sensorial saturation; an effective analgesic tool for heel-prick in preterm infants. Biol Neonate 80: 15–18

    Article  PubMed  CAS  Google Scholar 

  14. Blass EM, Watt LB (1999) Suckling- and sucrose-induced analgesia in human newborns. Pain 83: 611–23

    Article  PubMed  CAS  Google Scholar 

  15. Brent A StG (2000) The management of pain in the emergency department. Ped Clin North Am 47: 651–679

    Article  CAS  Google Scholar 

  16. Calobrisi SD, Drolet BA, Esterly NB (1998) Petechial eruption after the application of EMLA cream. Pediatrics 101: 471–473

    Article  PubMed  CAS  Google Scholar 

  17. Carbajal R, Chauvet X, Couderc S, Olivier-Martin M (1999) Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ 19: 1393–1397

    Article  Google Scholar 

  18. Chay PCW, Duffy BJ, Walker JS (1992) Pharmacokinetic-pharmacodynamic relationship of morphine in neonates. Clin Pharmacol Ther 51: 334–342

    Article  PubMed  CAS  Google Scholar 

  19. Derbyshire SWG, Furedi A (1996) “Fetal pain“ is a misnomer. BMJ 313: 795

    Google Scholar 

  20. Dickenson A, Rahman W (1999) Mechanisms of chronic pain and the developing nervous system. In: McGrath PJ, Finley GA (Hrsg) Chronic and recurrent pain in children and adolescents. IASP Press, Seattle, S 5–39

    Google Scholar 

  21. Dripps RD, Eckenhoff JE, Vandam LD (1982) Introduction to anesthesia. The principles of safe practice. Saunders, Philadelphia, S 152–154

    Google Scholar 

  22. Field T (1982) Alleviating stress in newborn infants in the intensive care unit. Clin Perinat 17: 1–9

    Google Scholar 

  23. Fitzgerald M, Beggs S (2001) The neurobiology of pain: Developmental aspects. Neuroscien-tist 7: 246–257

    Article  CAS  Google Scholar 

  24. Franck LS, Miaskowski C (1997) Measurement of neonatal responses to painful stimuli: A research review. J Pain Symptom Manage 14: 343–378

    Article  PubMed  CAS  Google Scholar 

  25. Franck LS, Miaskowski C (1998) The use of intravenous opioids to provide analgesia in critically ill, premature neonates: A research critique. J Pain Symptom Manage 15: 41–69

    Article  PubMed  CAS  Google Scholar 

  26. Gorski PA, Huntington L, Lewkowicz DJ (1990) Handling preterm infants in hospitals. Clin Perinatol 17: 103–112

    PubMed  CAS  Google Scholar 

  27. Gray L, Watt L, Blass EM (2000) Skin-to-skin contact is analgesic in healthy newborns. Pediatrics 105: 14

    Article  Google Scholar 

  28. Grunau RE, Oberlandr T, Holsti L, Whilfield MF (1998) Bedside application of the Neonatal Facial Coding System in pain assessment of premature neonates. Pain 76: 277–286

    Article  PubMed  CAS  Google Scholar 

  29. Guinsburg RG, Kopelman BI, Anand KJS, de Almeida MFB, Peres CA, Miyoshi MH (1998) Physiological, hormonal, and behavioral responses to a single fentanyl dose in intubated and ventilated preterm neonates. J Pediatr 132: 954–959

    Article  PubMed  CAS  Google Scholar 

  30. Hartley R, Quinn M, Green M, Levene MI (1993) Morphine glucuronidation in premature neonates. Br J Clin Pharmac 35: 314–317

    CAS  Google Scholar 

  31. Holliday MA, Pinckert TL, Kiernan SC, Kunos I, Angelus P, Keszler M (1999) Dorsal penile nerve block vs topical placebo for circumcision in low-birth-weight neonates. Arch Pediatr Adolesc Med 153: 476–480

    Article  PubMed  CAS  Google Scholar 

  32. Isbister GK, Bucens IK, Whyte IM (2001) Paracetamol overdose in a preterm neonate. Arch Dis Child 85: F70-F72

    Article  CAS  Google Scholar 

  33. Johnston CC, Collinge JM, Henderson SJ, Anand KJS (1997) A cross-sectional survey of pain and pharmacological analgesia in Canadian neonatal intensive care units. Clin J Pain 13: 308–312

    Article  PubMed  CAS  Google Scholar 

  34. Johnston CC, Sherrard A, Stevens B, Franck L, Stremler R, Jack A (1999) Do cry features reflect pain intensity in preterm neonates? A preliminary study. Biol Neonate 76: 120–124

    Article  PubMed  CAS  Google Scholar 

  35. Johnston CC, Stremler RL, Stevens BJ, Horton LJ (1997) Effectiveness of oral sucrose and simulated rocking on pain response in preterm neonates. Pain 72: 193–199

    Article  PubMed  CAS  Google Scholar 

  36. Johnston CC, Stremler R, Horton L, Friedman A (1999) Effect of repeated doses of sucrose during heel stick procedures in preterm neonates. Biol Neonate 75: 60–66

    Article  Google Scholar 

  37. Kart T, Christrup LL, Rasmussen M (1997) Recommended use of morphine in neonates, infants and children based on a literature review, pt 1: Pharmacokinetics. Paediatr Anaesth 7: 5–11

    Article  PubMed  CAS  Google Scholar 

  38. Kart T, Christrup LL, Rasmussen M (1997) Recommended use of morphine in neonates, infants and children based on a literature review, pt 2: Clinical use. Paediatr Anaesth 7: 93–101

    Article  PubMed  CAS  Google Scholar 

  39. Kennedy KA, Tyson JE (1999) Narcotic analgesia for ventilated newborns: Are placebo-controlled trials ethical and necessary? J Pediatr 134: 127–129

    Article  PubMed  CAS  Google Scholar 

  40. Lago P, Benini F, Agosto C, Zacchello F (1998) Randomised controlled trial of low dose fentanyl infusion in preterm infants with hyaline membrane disease. Arch Dis Child Fetal Neonatal Ed 79: F194–197

    Article  PubMed  CAS  Google Scholar 

  41. Larsson BA (1999) Pain management in neonates. Acta Paediatr 88: 1301–1310

    Article  PubMed  CAS  Google Scholar 

  42. Larsson BA, Tannfeldt G, Lagercrantz H, Ois-son GL (1998) Alleviation of the pain of venepuncture in neonates. Acta Paediatr 87: 774–779

    Article  PubMed  CAS  Google Scholar 

  43. Larsson BA, Tannfeldt G, Lagercrantz H, Ois-son GL (1998) Venipuncture is more effective and less painful than heel lancing for blood tests in neonates. Pediatrics 101: 882–886

    Article  PubMed  CAS  Google Scholar 

  44. Lee TC, Charles BG, Harte GJ, Gray PH, Steer PA, Flenady VJ (1999) Population pharmacokinetic modeling in very premature infants receiving midazolam during mechanical ventilation. Anesthesiology 90: 151–157

    Article  Google Scholar 

  45. Lewindon PJ, Harkness L, Lewindon N (1998) Randomised controlled trial of sucrose by mouth for the relief of infant crying after immunisation. Arch Dis Child 78: 453–6

    Article  PubMed  CAS  Google Scholar 

  46. Loyd-Thomas AR (1997) Paediatric pain management — the next step? Paediatric Anaesthesia 7: 487–493

    Article  Google Scholar 

  47. Lloyd-Thomas AR, Fitzgerald M (1996) Reflex responses do not necessarily signify pain. BMJ 313: 797–798

    Article  PubMed  CAS  Google Scholar 

  48. Lynn A, Nespeca MK, Bratton SL, Strauss SG, Shen DD (1998) Clearance of morphine in postoperative infants during intravenous infusion: The influence of age and surgery. Anesth Analg 86: 958–963

    PubMed  CAS  Google Scholar 

  49. MacGregor R, Evans E, Sugden D, Gaussen T, Levene M (1998) Outcome at 5–6 years of prematurely born children who received morphine as neonates. Arch Dis Child Fetal Neonatal Ed 79: F40–43

    Article  PubMed  CAS  Google Scholar 

  50. Marsh DF, Hatch DJ, Fitzgerald M (1997) Opioid systems and the newborn. Br J Anaesthesia 79: 787–795

    Article  CAS  Google Scholar 

  51. Maxwell LG, Yaster M (1999) Analgesia for neonatal circumcision. No more studies, just do it. Arch Pediatr Adolesc Med 153: 444–445

    PubMed  CAS  Google Scholar 

  52. Mcintosh N (1997) Pain in the newborn, a possible new starting point. Eur J Pediatr 156: 173–177

    Article  PubMed  CAS  Google Scholar 

  53. McLaughlin CR, Hull JG, Edwards WH, Cramer CP, Dewey WL (1993) Neonatal pain; a comprehensive survey of attitudes and practices. J Pain Symptom Manage 8: 7–16

    Article  PubMed  CAS  Google Scholar 

  54. Oberlander TF, Grunau RE; Whitfield MF, Fitzgerald C, Pitfield S, Saul JP (2000) Biobe-havioral pain responses in former extremely low birth weight infants at four months’ corrected age. Electronic Abstr: http://www.pedi-atrics.org #e6 page 107

    Google Scholar 

  55. Ö rs R, Ö zek E, Baysoy G, Cebeci D, Bilgen H, Türküner M, Basaran M (1999) Comparison of sucrose and human milk on pain response in newborns. Eur J Pediatr 158: 63–66

    Article  PubMed  Google Scholar 

  56. Pasternak GW, Zhang A, Tecott L (1980) Developmental differences between high and low affinity binding sites: their relationship to analgesia and respiratory depression. Life Science 27: 1185–1190

    Article  CAS  Google Scholar 

  57. Playfor SD, Thomas DA, Choonara I, Jarvis A (2000) Quality of sedation during mechanical ventilation. Paediat Anaesthesia 10: 195–199

    Article  CAS  Google Scholar 

  58. Pokela ML (1994) Pain relief can reduce hypoxemia in distressed neonates during routine treatment procedures. Pediatrics 93: 379–383

    PubMed  CAS  Google Scholar 

  59. Polander DM, Berde CB (1993) Postoperative pain management. In: Coté CJ, Ryan JF, Todres ID, Goudsouzian NG (Hrsg) A practice of anesthesia for infants and children. Saunders, Philadelphia, S 451–467

    Google Scholar 

  60. Porter FL, Wolf CM, Gold J, Lotsoff D, Miller JP (1997) Pain and pain management in newborn infants: A survey of physicians and nurses. Pediatrics 100: 626–632

    Article  PubMed  CAS  Google Scholar 

  61. Porter FL, Wolf CM, Miller JP (2000) Procedural pain in newborn infants: The influence of intensity and development. Electronic Ab-str: http://www.pediatrics.org #e13

    Google Scholar 

  62. Quinn MW, Wild J, Dean HG, Hartley R, Rush-forth JA, Puntis JWL, Levene MI (1993) Randomised double-blind controlled trial of effect of morphine on catecholamine concentrations in ventilated preterm babies. Lancet 342: 324–327

    Article  PubMed  CAS  Google Scholar 

  63. Ramenghi LA, Evans DJ, Levene MI (1999) “Sucrose analgesia”: absorptive mechanism or taste perception? Arch Dis Child Fetal Neonatal Ed 80: F146–147

    Article  PubMed  CAS  Google Scholar 

  64. Saarenman E, Huttunen P, Leppäluoto J, Mere-tojy O, Fellmann V (1999) Advantages of fen-tanyl over morphine in analgesia for ventilated newborn infants after birth. A randomized trial. J Pediatr 134: 144–150

    Article  Google Scholar 

  65. Schuster A, Lenard HG (1990) Pain in newborns and prematures: Current practice and knowledge. Brain Dev 12: 459–465

    Article  PubMed  CAS  Google Scholar 

  66. Shah V, Taddio A, Ohlsson A (1998) Randomised controlled trial of paracetamol for heel prick pain in neonates. Arch Dis Child Fetal Neonatal Ed 79: F209–211

    Article  PubMed  CAS  Google Scholar 

  67. Shah V, Ohlsson A (2001) Venepuncture vs. heel lance for blood sampling in term neonates. In: The Cochrane Library, Issue 3, Oxford: Update software

    Google Scholar 

  68. Skogsdal Y, Eriksson M, Schollin J (1997) Analgesia in newborns given oral glucose. Acta Paediatr 86: 217–220

    Article  PubMed  CAS  Google Scholar 

  69. Stevens B, Johnston C, Franck L, Petryshen P, Jack A, Foster G (1999) The efficacy of develop-mentally sensitive interventions and sucrose for relieving procedural pain in very low birth weight neonates. Nurs Res 48: 35–43

    Article  PubMed  CAS  Google Scholar 

  70. Stevens B, Ohlsson A (2000) Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev 2: CD001069

    PubMed  Google Scholar 

  71. Stevens B, Taddio A, Ohlsson A, Einarson T (1997) The efficacy of sucrose for relieving procedural pain in neonates — a systematic review and meta-analysis. Acta Paediatr 86: 837–842

    Article  PubMed  CAS  Google Scholar 

  72. Suresh S, Anand KJS (2001) Opioid tolerance in neonates: a state-of-the-art review. Paediatr Anaesthesia 11: 511–521

    Article  CAS  Google Scholar 

  73. Taddio A, Katz J, Illersich AL, Koren G (1997) Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet 349: 599–603

    Article  PubMed  CAS  Google Scholar 

  74. Tobias JD, Rasmussen GE (1994) Pain management and sedation in the pediatric intensive care unit. Ped Clin North Am 41: 1269–1292

    CAS  Google Scholar 

  75. Van Howe RS (1997) Neonatal circumcision. Lancet 349: 1257

    Article  PubMed  Google Scholar 

  76. Van Lingen RA, Deinum JT, Quak JME, Kzizen-ga AJ, van Dam JG, Anand KJS, Tibboel D, Okken A (1999) Pharmacokinetics and metabolism of rectally administered paracetamol in preterm neonates. Arch Dis Child Fetal Neonatal Ed 80: F59–63

    Article  PubMed  Google Scholar 

  77. Van Lingen RA, Deinum HT, Quak CME, Okken A, Tibboel D (1999) Multiple-dose pharmacokinetics of rectally administered acetaminophen in term infants. Clin Pharmacol Ther 66: 509–515

    Article  PubMed  Google Scholar 

  78. Winberg J (1998) Do neonatal pain and stress program the brain’s response to future stimuli? Acta Paediatr 87: 723–725

    Article  PubMed  CAS  Google Scholar 

  79. Wolf AR (1997) Pain, nociception and the developing infant. Paediatr Anaesth 9: 7–17

    Article  Google Scholar 

  80. Wood CM, Rushford JA, Hartley R, Dean H, Wild J, Levine MI (1998) Randomised double blind trial of morphine vs. diamorphine for sedation of preterm neonates. Arch Dis Child Fetal Neonatal Ed 79: F34–39

    Article  PubMed  CAS  Google Scholar 

  81. Yaster M, Bean J D, Schulman SR, Rogers MC (1996) Pain, sedation, and postoperative anesthetic management in the pediatric intensive care unit. In: Rogers M (Hrsg) Textbook of pediatric intensive care. Williams & Wilkins, Baltimore, S 1547–1593

    Google Scholar 

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Michel, E., Zernikow, B. (2003). Schmerztherapie auf der (neonatologischen) Intensivstation. In: Zernikow, B. (eds) Schmerztherapie bei Kindern. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09814-1_17

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  • DOI: https://doi.org/10.1007/978-3-662-09814-1_17

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