Contenuto dell'articolo principale

Abstract

Introduzione: La misurazione del dolore è il prerequisito fondamentale per un’adeguata gestione. Poiché il neonato è incapace di comunicare verbalmente, sono state elaborate numerose scale algometriche specifiche per l’epoca neonatale. Tuttavia, non esiste una scala adottata universalmente o significativamente più efficace di altre.


Obiettivo: Individuare e classificare le scale più idonee ed efficaci nella misurazione dei diversi tipi di dolore nel neonato a termine e pretermine in diversi contesti clinici.


Metodi: Tra Dicembre 2019 e Novembre 2020 sono state consultate le banche dati scientifiche PubMed e CINAHL, combinando in maniera crociata termini Mesh e parole semplici, applicando filtri di inclusione ed esclusione adeguati. Inoltre, sono state analizzate le voci bibliografiche citate negli articoli reperiti nella prima parte della ricerca.


Risultati: Dei 2442 record inizialmente individuati, sono stati inseriti nella revisione un totale di 45 articoli, in cui sono descritte 50 scale algometriche (34 per il dolore acuto, 12 per quello procedurale, 24 per quello prolungato/cronico e 19 per quello post-operatorio). Le scale supportate da maggiori evidenze sono N-PASS, NFCS, BIIP e PIPP per il dolore acuto e procedurale, N-PASS, ALPS-Neo, EDIN e EDIN6 per il dolore prolungato e cronico e PIPP, CRIES e COMFORT per quello post-operatorio.


Conclusioni: Allo stato attuale, non esiste una scala per la misurazione del dolore neonatale accettata unanimemente come gold standard. Tuttavia, alcune sono più idonee ed efficaci: per il dolore acuto PIPP, NFCS, N-PASS e BIIP, per il dolore cronico e prolungato N-PASS, ALPS-Neo ed EDIN/EDIN6 e per il dolore postoperatorio PIPP, CRIES e COMFORT. Tra tutte, la N-PASS è la più completa e adatta a contesti differenti.


Parole chiave: Neonato, dolore, valutazione del dolore, scala di misurazione del dolore. 

Parole chiave

neonato dolore scale di misurazione infermieri valutazione newborn pain pain assessment pain mesaurement scale

Dettagli dell'articolo

Come citare
Castagno, E., Fabiano, G., Carmellino, V., Cerchio, R., De Vito, B., Lauria, B., Mercurio, G., Coscia, A., Ponte, G., & Bondone, C. (2022). Scale di misurazione del dolore nel neonato: revisione della letteratura. PROFESSIONI INFERMIERISTICHE, 75(1). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/1015

Riferimenti

  • Arias, M.C.C., & Guinsburg, R. (2012). Differences between uni- and multidimensional scales for assessing pain in term newborn infants at the bedside. Clinics (Sao Paulo), 67(10), 1165-1170.
  • Association of Paediatric Anaesthetists of Great Britain and Ireland. (2012). Good practice in postoperative and procedural pain management, 2nd Edition. Pediatric Anesthesia, 22(Suppl.1), 1-79.
  • Avila-Alvarez, A., Carbajal, R., Courtois, E., Pertega-Diaz, S., Anand,K.J.S., Mun˜iz-Garcia, J., et al. (2016). Clinical assessment of pain in Spanish Neonatal Intensive Care Units. Anales de Pediatria, 85(4), 181-188.
  • Bai, J., & Jiang, N. (2015). Where are we: a systematic evaluation of the psychometric properties of pain assessment scales for use in chinese children pain management nursing. Pain Management Nursing, 16(4), 617-631.
  • Bellieni, C.V. (2019). New insights into fetal pain. Seminars of Fetal and Neonatal Medicine, 24(4), Article 101001.
  • Beltramini, A., Galinski, M., Chabernaud, J.L., Almenar, R.R., Tsapis, M., Goddet, N.S., et al. (2019). Pain assessment in children younger than 8 years in out-of-hospital emergency medicine reliability and validity of evendol score. Pediatric Emergency Care, 35(2), 125-131.
  • Beltramini, A., Milojevic, K., & Pateron, D. (2017). Pain assessment in newborns, infants and children. Pediatrics Annals, 46(10), e387-e395.
  • Benini, F., Corsini, I., Castagno, E., Silvagni, D., Lucarelli, A., Giacomelli, L., et al. (2020). Consensus on pediatric pain in the emergency room: the COPPER Project, issued by 17 Italian scientific societies. Italian Journal of Pediatrics, 46(1), 101.
  • Cignacco, E., Hamers, J.P.H., Stoffel, L., van Lingen, R.A., Gessler, P., McDougall, J., et al. (2007). The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates. A systematic literature review. European Journal of Pain, 11(2), 139–152.
  • Cignacco, E., Schenk, K., Stevens, B., Stoffel, L., Bassler, D., Schulzk,e S., et al. (2017). Individual contextual factors in the validation of the Bernese pain scale for neonates: protocol for a prospective observational study. BMC Pediatrics, 17(1), Article 171.
  • Committee on Fetus and Newborn, Section on Anesthesiology and Pain Medicine. (2016). Prevention and management of procedural pain in the neonate: an update. American Academy of Pediatricians, 137, e20154271.
  • Cruz, M.D., Fernandes, A.M., & Oliveira, C.R. (2016). Epidemiology of painful procedures performed in neonates: A systematic review of observational studies. European Journal of Pain, 20(4), 489–498.
  • Cury, M., Martinez, F.E., & Carlotti, A.P.C.P. (2013). Pain assessment in neonates and infants in the post-operative period following cardiac surgery. Postgraduate Medicine Journal, 89(1048), 63-67.
  • De Lima, J., & Browning Carmo, K. (2010). Practical pain management in the neonate. Best Practice Research in Clinical Anaesthesiology, 24(3), 291-307.
  • Eriksson, M., & Campbell-Yeo, M. (2019). Assessment of pain in newborn infants. Seminars of Fetal and Neonatal Medicine, 24(4), 101003.
  • De Melo, G.M., Lélis, A.L., de Moura, A.F., Cardoso, M.V., & da Silva, V.M. (2014) Pain assessment scales in newborns: integrative review. Revista Paulista de Pediatria, 32(4), 395-402.
  • Desai, A., Aucott, S., Frank, K., & Silbert-Flagg, J. (2018). Comparing N-PASS and NIPS improving pain measurement in the neonate. Advanced Neonatal Care, 18(4), 260-266.
  • Dias, F.S.B., Gasparino, R.C., Carmona, E.V., & Marba, S.T.M. (2017). Validation of the Échelle Douleur Inconfort Nouveau-Né for Brazilian culture. Revista de Escola de Enfermagem da USP, 51, e03285.
  • Dionysakopoulou, C., Giannakopoulou, M., Lianou, L., Bozas, E., Zannikos, K., & Matziou, V. (2018). Validation of greek versions of the Neonatal Infant Pain Scale and Premature Infant Pain Profile in Neonatal Intensive Care Unit. Pain Management Nursing, 19(3), 313-319.
  • Doesburg, S.M., Chau, C.M., Cheung, T.P.L., Moiseev, A., Ribary, U., Herdman, A.T., et al. (2013). Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestational age. Pain, 154(10), 1946-1952.
  • Field, T. (2017). Preterm newborn pain research review. Infant Behaviour and Development, 49, 141-150.
  • Franck, L.S., Ridout, D., Howard, R., Peters, J., & Honour, J.W. (2011). A comparison of pain measures in newborn infants after cardiac surgery. International Association for the Study of Pain, 152(8), 1758-1765.
  • Garten, L., Deindl, P., Schmalisch, G., Metze, B., & Bührer, C. (2010). Parallel assessment of prolonged neonatal distress by empathy-based and item-based scales. European Journal of Pain, 14(8), 878-881.
  • Gibbins, S., Stevens, B.J., Yamada, J., Dionne, K., Campbell-Yeo, M., Lee, G., et al. (2014). Validation of the Premature Infant Pain Profile-Revised (PIPP-R). Early Human Development, 90(4), 189-193.
  • Giordano, V., Edobor, J., Deindl, P., Wildner, B., Goeral, K., Steinbauer, P., et al. (2019). Pain and sedation scales for neonatal and pediatric patients in a preverbal stage of development. A systematic review. JAMA Pediatrics, 173, 1186-1197.
  • Hall, R.W., & Anand, K.J. (2014). Pain management in newborns. Clinical Perinatology, 41(4), 895-924.
  • Hand, I.L., Noble, L., Geiss, D., Wozniak, L., & Hall, C. (2010). COVERS Neonatal Pain Scale: development and validation. International Journal of Pediatrics, 2010, 496719.
  • Hatfield, L.A., Murphy, N., Karp, K., & Polomano, R.C. (2019). A Systematic Review of Behavioral and Environmental Interventions for Procedural Pain Management in Preterm Infants. Journal of Pediatric Nursing, 44, 22–30.
  • Herr, K., Coyne, P.J., Key, T., Manworren, R., McCaffery, M., Merkel, S., et al. (2006). Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Management Nursing, 7(2), 44-52.
  • Hillman, B.A., Tabrizi, M.N., Gauda, E.B., Carson, K.A., & Aucott, S.W. (2015) The Neonatal Pain, Agitation and Sedation Scale and the bedside nurse’s assessment of neonates. Journal of Perinatology, 35(2), 128-131.
  • Huang, X.Z., Li, L., Zhou, J., He, F., Zhong, C.X., & Wang, B. (2018). Evaluation of three pain assessment scales used for ventilated Neonates. Journal of Clinical Nursing, 27(19-20), 3522-3529.
  • Hummel, P., Lawlor-Klean, P., & Weiss, M.G. (2010). Validity and reliability of the N-PASS assessment tool with acute pain. Journal of Perinatology, 30(7), 474-478.
  • Kappesser, J., de Laffolie, J., Faas, D., Ehrhardt, H., & Hermann, C. (2019). Comparison of two neonatal pain assessment tools (Children and Infant’s Postoperative Pain Scale and the Neonatal Facial Coding System-Revised) and their relations to clinicians’ intuitive pain estimates. European Journal of Pain, 23(4), 708-718.
  • Liaw, J.J., Yang, L., Chou, H.L., Yin, T., Chao, S.C., Lee, T.Y. (2012). Psychometric analysis of a Taiwan-version pain assessment scale for preterm infants. Journal of Clinical Nursing, 21(1-2), 89-100.
  • Lundqvist, P., Kleberg, A., Edberg, A.K., Larsson, B.A., Hellström-Westas, L., & Norman, E. (2014). Development and psychometric properties of the Swedish ALPS-Neo pain and stress assessment scale for newborn infants. Acta Paediatrica, 103(8), 833-839.
  • Milesi, C., Cambonie, G., Jacquot, A., Barbotte, E., Mesnage, R., Masson, F., et al. (2010). Validation of a neonatal pain scale adapted to the new practices in caring for preterm newborns. Archives of Disease in Childhood Fetal and Neonatal Edition, 95(4), F263-266.
  • O'Neal, K., & Olds, D. (2016). Differences in pediatric pain management by unit types. Journal of Nursing Scholarship, 48(4), 378-386.
  • Orzalesi, M. (2018). Pain in children remains an unsolved problem. Acta Paediatrica 107(10), 1665-1666.
  • O'Sullivan, A.T., Rowley, S., Ellis, S., Faasse, K., & Petrie, K.J. (2016). The validity and clinical utility of the COVERS Scale and Pain Assessment Tool for assessing pain in neonates admitted to an Intensive Care Unit. Clinical Journal of Pain, 32(1), 51-57.
  • Perry, M., Tan, Z., Chen, J., Weidig, T., Xu, W., & Cong, X.S. (2018). Neonatal pain: perceptions and current practice. Critical Care Nursing Clinics of North America, 30(4), 549-561.
  • Pölkki, T., Korhonen, A., Axelin, A., Saarela, T., & Laukkala, H. (2014). Development and preliminary validation of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS). International Journal of Nursing Studies, 51(12), 1585-1594.
  • Raffaeli, G., Cristofori, G., Befani, B., De Carli, A., Cavallaro, G., Fumagalli, M., et al. (2017). EDIN Scale Implemented by Gestational Age for Pain Assessment in Preterms: A Prospective Study. Biomed Research International, 2017, Article 9253710.
  • Reavey, D.A., Haney, B.M., Atchison, L., Anderson, B., Sandritter, T., & Pallotto, E.K. (2014). Improving pain assessment in the NICU. A quality improvement project. Advanced Neonatal Care, 14(3), 144-153.
  • Rodríguez, M.C., Villamor, P., & Castillo, T. (2016). Assessment and management of pain in pediatric otolaryngology. International Journal of Pediatric Otorhinolaringology, 90, 138-149.
  • Schenk, K., Stoffel, L., Bürgin, R., Stevens, B., Bassler, D., Schulzke, S., et al. (2019). The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates. BMC Pediatrics, 19(1), 20.
  • Shah, P., & Siu, A. (2019). Considerations for neonatal and pediatric pain management. American Journal of Health-System Pharmacy, 76(19), 1511-1520.
  • Slater, R., Fabrizi, L., Worley, A., Meek, J., Boyd, S., & Fitzgerald, M. (2010). Premature infants display increased noxious-evoked neuronal activity in the brain compared to healthy age-matched term-born infants. Neuroimage, 52(2), 583-589.
  • Spasojevic, S., & Bregun-Doronjski, A. (2011). A simultaneous comparison of four neonatal pain scales in clinical settings. Journal of Maternal, Fetal and Neonatal Medicine, 24(4), 590-594.
  • Stapelkamp, C., Carter, B., Gordon, J., & Watts, C. (2011) Assessment of acute pain in children: development of evidence-based guidelines. International Journal of Evidence Based Health, 9(1), 39-50.
  • Stevens, B.J., Gibbins, S., Yamada, J., Dionne, K., Lee, G., Johnston, C., et al. (2014). The Premature Infant Pain Profile-Revised (PIPP-R). Initial validation and feasibility. Clinical Journal of Pain, 30(3), 238-243.
  • Stevens, B., Johnston, C., Taddio, A., Gibbins, S., & Yamada, J. (2010). The premature infant pain profile: evaluation 13 years after development. Clinical Journal of Pain, 26(9), 813-830.
  • Walker, S.M. (2019) Long-term effects of neonatal pain. Seminars of Fetal and Neonatal Medicine, 24(4), Article 101005.
  • Witt, N., Coynor, S., Edwards, C., & Bradshaw, H. (2016). A guide to pain assessment and management in the neonate. Current Emergency Hospital Medicine Report, 4, 1-10.
  • Woragidpoonpol, P., Tiansawad, S., Mesukko, J., & Klunklin, P. (2018). Development of a clinical pain scale for preterm neonates. Pacific Rim International Journal of Nursing Research, 22(4), 347-359.
  • Zieliski, J., Morawska-Kochman, M., & Zatoński, T. (2020). Pain assessment and management in children in the postoperative period: a review of the most commonly used postoperative pain assessment tools, new diagnostic methods and thelatest guidelines for postoperative pain therapy in children. Advances in Clinical and Experimental Medicine, 29(3), 365-374.