• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.52-57
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• 2006

Objective : It has been suggested that the occurrence of persistent pain signal during the early postnatal period may alter an individual's response to pain later in life. The aim of this study is to assess whether neonatal nerve injury resulted in long-lasting consequences on nociceptive system in the rat. Methods : We examined whether neuropathic pain behaviors and the changes of spinal neuropeptides [SP, CGRP, VIP and VIP] induced by peripheral nerve injury within 1 day after birth [Neonate group] were different from those at 8 weeks after birth [Mature group]. Results : The Neonate group showed more robust and long-lasting pain behaviors than the Mature group. Immunohistochemical findings demonstrated that spinal SP- & CGRP-immunoreactivities[ir] of the ipsilateral to the contralateral side increased in the Neonate group, whereas those decreased in the Mature group. In addition, increase in spinal VIP- & NPY-ir of the ipsilateral to the contralateral side was more robust in the Mature group than in the Neonate group. Conclusion : These results suggest that peripheral nerve injury in the early postnatal period may result in long-lasting and potentially detrimental alterations in nociceptive pathways.

• 여성건강간호학회지
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• 제7권2호
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• pp.188-202
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• 2001

This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

• Child Health Nursing Research
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• 제5권3호
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• pp.262-280
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• 1999

This study was Performed to understand Pediatric Pain management status and nurses' knowledge and attitudes toward it. In addition. it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit. oncology unit, neonatal unit. neonatal ICU, Pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective Pain management was used. Results of this study are summarized as follows 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%) And almost nurses(90.8%) don't used to utilize pain assessment tool, but the 'Faces Rating Scale' is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%) , distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric Physical development (Mn = 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively Quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to Pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration' Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).

• Neonatal Medicine
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• 제18권2호
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• pp.353-358
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• 2011

목적: 건강한 신생아를 대상으로 B형 간염 예방접종 시 25% 경구 포도당과 인공젖꼭지의 진통효과를 알아보고자 전향적 부분적 무작위 임상실험을 시행하였다. 방법: 132명의 신생아를 대상으로, 출생 6시간 이후 B형 간염 예방접종을 근육 내 주사하여 비약물적 통증조절 방법을 비교하였다. 4가지 번호가 담긴 성별에 따라 구분된 상자를 통해 무작위 추첨으로 각 실험군을 정하였고, 주사 투여 2분 전에 증류수를 먹인 군을 대조군으로 25% 경구 포도당을 먹인 군(포도당 처치군), 주사 투여 전 2분 동안 인공젖꼭지만 물린 군(인공젖꼭지 처치군) 및 25% 경구 포도당을 인공젖꼭지에 묻혀 물린 군(포도당+인공젖꼭지 처치군)으로 총 4개의 군으로 구분하여 진행되었다. 모든 군에서 접종 전, 접종 시, 회복 시의 Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) 점수를 구하여 비교하였다. 결과: 산모와 대상아의 임상적 특징은 4개의 군 사이에 차이가 없었고, 대조군과 비교하여 포도당 처치군에서 NIPS 점수상 접종 시(6.4${\pm}$0.9 vs. 5.5${\pm}$1.7, P=0.01)와 회복 시(1.6${\pm}$2.0 vs. 0.6${\pm}$0.9, P=0.01), NFCS 점수상 회복 시(1.5${\pm}$2.3 vs. 0.7${\pm}$0.8, P=0.04)에 통증점수가 유의하게 낮음을 확인하였다. 또한 각 통증평가 점수상 통증이 있는 것으로 판단되는 대상(NIPS점수${\geq}$ 4점, NFCS점수${\geq}$3점)의 숫자가 의미 있게 감소하였다(9명 (23.1%) vs. 0명(0%), P=0.04 via NIPS, 7명(17.9%) vs. 0명(0%), P=0.02 via NFCS). 반면 모든 군 사이 PIPP 점수 혹은 중등도 혹은 심한 통증 PIPP 점수 대상수(PIPP점수${\geq}$7점)의 비교에서는 통계상 의미가 없었다. 그러나 대조군과 비교하여 인공젖꼭지 처치군에서 오히려 NIPS와 NFCS 점수가 각각 회복 시 통계상 유의하게 증가하였고(1.6${\pm}$2.0 vs. 2.7${\pm}$2.6, P=0.003 via NIPS, 1.5${\pm}$2.3 vs. 2.9${\pm}$2.6, P=0.023 via NFCS), 포도당+인공젖꼭지 처치군에서는 통계상 유의하지 않았다. 결론: 25% 경구 포도당을 이용한 통증조절은 효과가 있어 보이나 인공젖꼭지 혹은 25% 포도당을 묻힌 인공젖꼭지의 경우에는 효과가 없었다. 저자들은 본 연구 결과를 바탕으로 향후 신생아의 비약물적 통증조절에 대한 추가적 연구가 필요할 것으로 생각한다.

• 대한간호학회지
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• 제35권7호
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• Child Health Nursing Research
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• 제7권1호
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• pp.35-50
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• 2001

The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotrans-mitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO₂. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25％ sucrose). Collected data were analyzed with the SAS program using X²-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25％ sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO₂: The SaO₂ score of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO₂ score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.

• The Korean Journal of Pain
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• 제14권2호
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• pp.136-141
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• 2001

Background: Sodium salicylate (SS) is a nonsteroidal anti-inflammatory drug (NSAID) for the treatment of neuralgia or pain from rheumatoid arthritis. When abused or used in excess, SS can induce cytotoxicity. The present study examined whether SS has a neurotoxic effect. Methods: Cell viability was examined by MTT [3-(4,5-dimethylthiazol-2,5-dipheny ltetrazolium bromide] assay and Sulforhodamine (SRB) assay after cultivating dorsal root ganglion (DRG) neurons derived from neonatal mouse. These cells were treated with various concentrations of SS for 24 hours. In addition, the amount of protein synthesis against SS was measured in these cultures. Results: Cell viability (20, $40{\mu}g/ml$ SS) significantly decreased in a dose-dependent manner. Additionally, SS inhibited protein synthesis after the exposure of cultured mouse DRG neurons to $30{\mu}g/ml$ of SS for 24 hours. Conclusions: The present study suggests that SS is toxic in cultured DRG neurons derived from neonatal mouse by decreasing cell viability and the amount of protein synthesis.

• Clinical and Experimental Pediatrics
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• 제61권10호
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• pp.322-326
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• 2018

Purpose: The EDIN scale (${\acute{E}}chelle$ Douleur Inconfort Nouveau-$N{\acute{e}}$, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement due to pneumothorax. Methods: This prospective observational study assessed prolonged pain in preterm infants with a gestational age between 33 and 35 weeks undergoing installation of chest tubes. Prolonged pain was assessed using the EDIN scale and NIPE index. Results: There was a significant correlation between the EDIN scale and NIPE index (r=-0.590, P=0.003). Prolonged pain is significantly more severe in the first 6 hours following chest tube installation (NIPE index: 60 [50-86] vs. 68 [45-89], P<0.002; EDIN score: 8 [7-11] vs. 6 [4-8], P<0.001). Conclusion: Prolonged pain can be accurately assessed with the EDIN scale and NIPE index. However, evaluation with the EDIN scale is time-consuming. The NIPE index can provide instantaneous assessment of prolonged and continuous pain.

• Clinical and Experimental Pediatrics
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• 제63권1호
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• pp.16-17
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• 2020

• Child Health Nursing Research
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• 제24권4호
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• pp.407-419
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• 2018

Purpose: The purpose of this study was to explore and describe the meaning and essence of a mother's experience of hospitalization of her newborn in the neonatal intensive care unit (NICU). Methods: This study employed a qualitative research design. An interview was conducted with a mother whose newborn was hospitalized in the NICU, and the data were analyzed using Giorgi's phenomenological method. Results: Five main themes and 19 formulated meanings were indentified. The 5 themes were 'drowning in pain', 'just look outside the glass door', 'being a pillar', 'a deepening attachment', and 'prepare for nurturing with hope'. Conclusion: The results of this study provided an in-depth understanding of the experience of a mother with a newborn in the NICU. These results can be used in the development of a nursing intervention program that provides psychological and emotional support to the mother and family.