Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva

Detalhes bibliográficos
Autor(a) principal: Guimar??es, Andr?? Gustavo Moura
Data de Publicação: 2018
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/1888
Resumo: Introduction: neonatal pain results in neurobiological effects, and changes in behavioral reactions of children who were born prematurely. There is no clear description about the pain caused by chest physiotherapy technique, nor about the possible non-pharmacological interventions to prevent it. Objective: to evaluate neonatal pain and physiological parameters during the chest physiotherapy in premature neonates (PTNB) in neonatal intensive care. Method: a randomized controlled trial, not blinded, in which 120 PTNB in mechanical ventilation were studied. They were randomized into four groups: control group (CG), diaphragmatic stimulation group (EDG), manual hyperinflation group (MHG), thoracic vibration group (VTG), containing 30 individuals in each one. The protocol consisted of 3 phases, the first phase being considered the control, and the other associated with non-pharmacological techniques to reduce pain: application of the technique (phase 1), application of technique + facilitated tucking (phase 2), application of technique + glucose (phase 3). Heart rate (HR), respiratory rate (RR), SpO2, Behavioral pain scale Indicators of Infant Pain (BIIP, ranges from 0 to 10) and Neonatal Infant Pain Scale (NIPS, ranges from 0 -7) were recorded at pre, during and after (15 minutes) the procedures described. Results: 62 (51.66%) RNPT were female, and most considered small for gestational age (83, 69%). Physiological variables (HR, FR, and SpO2) behaved in a similar manner in all groups (CG, MHG, EDG, VTG), being greater in phase 1, however these variables were reduced at phase 2 and 3 (p < 0.05). This means that during the application of non-pharmacological intervention (facilitated tucking or glucose) there was reduction of those variables. BIIP and NIPS scales showed increased in all of the groups in the phase 1 during the application of the techniques, however, similar to the physiological variables, these scales had reduced scores when applied to facilitated tucking (phase 2) or glucose (phase 3), p < 0.05. The number of individuals who have had pain assessed by BIIP (> 3 points) at the moment after in the phase 1 was 83 (69%), in phase 2 was 22 (18%), and in phase 3 of 34 (28%), p < 0.001. Conclusions: The chest physiotherapy techniques can increase the pain in PTNB, however, the non-pharmacological techniques, such as facilitated tucking and glucose, were able to reduce it.
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spelling Lanza, Fernanda de CordobaSaraty, Salma BritoLanza, Fernanda de CordobaCorso, Simone DalJorge, Luciana Maria Malos?? SampaioJos??, Andersonhttp://lattes.cnpq.br/7135874493191606Guimar??es, Andr?? Gustavo Moura2018-07-20T19:48:50Z2018-03-06Guimar??es, Andr?? Gustavo Moura. Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva. 2018. 114 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.http://bibliotecatede.uninove.br/handle/tede/1888Introduction: neonatal pain results in neurobiological effects, and changes in behavioral reactions of children who were born prematurely. There is no clear description about the pain caused by chest physiotherapy technique, nor about the possible non-pharmacological interventions to prevent it. Objective: to evaluate neonatal pain and physiological parameters during the chest physiotherapy in premature neonates (PTNB) in neonatal intensive care. Method: a randomized controlled trial, not blinded, in which 120 PTNB in mechanical ventilation were studied. They were randomized into four groups: control group (CG), diaphragmatic stimulation group (EDG), manual hyperinflation group (MHG), thoracic vibration group (VTG), containing 30 individuals in each one. The protocol consisted of 3 phases, the first phase being considered the control, and the other associated with non-pharmacological techniques to reduce pain: application of the technique (phase 1), application of technique + facilitated tucking (phase 2), application of technique + glucose (phase 3). Heart rate (HR), respiratory rate (RR), SpO2, Behavioral pain scale Indicators of Infant Pain (BIIP, ranges from 0 to 10) and Neonatal Infant Pain Scale (NIPS, ranges from 0 -7) were recorded at pre, during and after (15 minutes) the procedures described. Results: 62 (51.66%) RNPT were female, and most considered small for gestational age (83, 69%). Physiological variables (HR, FR, and SpO2) behaved in a similar manner in all groups (CG, MHG, EDG, VTG), being greater in phase 1, however these variables were reduced at phase 2 and 3 (p < 0.05). This means that during the application of non-pharmacological intervention (facilitated tucking or glucose) there was reduction of those variables. BIIP and NIPS scales showed increased in all of the groups in the phase 1 during the application of the techniques, however, similar to the physiological variables, these scales had reduced scores when applied to facilitated tucking (phase 2) or glucose (phase 3), p < 0.05. The number of individuals who have had pain assessed by BIIP (> 3 points) at the moment after in the phase 1 was 83 (69%), in phase 2 was 22 (18%), and in phase 3 of 34 (28%), p < 0.001. Conclusions: The chest physiotherapy techniques can increase the pain in PTNB, however, the non-pharmacological techniques, such as facilitated tucking and glucose, were able to reduce it.Introdu????o: A dor neonatal desencadeia efeitos neurobiol??gicos agudamente, e altera????es nas rea????es comportamentais da crian??a nascida prematuramente. N??o h?? descri????o clara sobre a dor ocasionada por t??cnicas manuais de fisioterapia respirat??ria, tampouco sobre as poss??veis interven????es n??o farmacol??gicas na preven????o da mesma. Objetivo: Avaliar a dor neonatal e par??metros fisiol??gicos durante a fisioterapia respirat??ria em neonatos prematuros na UTI neonatal. Metodologia: ensaio cl??nico randomizado controlado, n??o cego, no qual foram estudados 120 rec??m-nascidos prematuros (RNPT), de ambos os sexos, em ventila????o mec??nica. Foram randomizados em quatro grupos: grupo controle (GC), grupo estimula????o diafragm??tica (GED), grupo hiperinsufla????o manual (GHM), grupo vibra????o tor??cica (GVT), contendo 30 indiv??duos em cada. O protocolo constou de 3 fases, sendo a primeira fase considerada a controle, e as demais associadas a t??cnicas n??o farmacol??gicas de redu????o da dor: aplica????o da t??cnica (fase 1), aplica????o da t??cnica e conten????o (fase 2), aplica????o da t??cnica e glicose (fase 3). A frequ??ncia card??aca (FC), respirat??ria (FR), SpO2, escala de dor Behavioral Indicators of Infant Pain (BIIP, varia de 0 a 10) e Neonatal Infant Pain Scale (NIPS, varia de 0 -7) foram registradas pr??, durante e ap??s (15 minutos) dos procedimentos em cada fase descrita. Resultados: 62 (51,66%) dos RNPT do sexo feminino, e a maioria considerados pequenos para idade gestacional (83 ???69%???). As vari??veis fisiol??gicas (FC, FR, e SpO2) se comportaram de maneira semelhante, em todos os grupos, sendo maior na fase 1, reduzindo nas fases 2 e 3 (p<0,05). Durante a aplica????o de interven????o n??o farmacol??gica (conten????o ou glicose) houve redu????o daquelas vari??veis. As escalas BIIP e NIPS mostraram aumento em todos dos grupos na fase 1 durante a aplica????o das t??cnicas, sendo reduzida a dor quando aplicado a conten????o (fase 2) ou a glicose (fase 3), p< 0,05. O n??mero de indiv??duos que tiveram dor avaliado pela BIIP (> 3 pontos) no momento ap??s na fase 1 foi 83 (69%), na fase 2 foi 22 (18%), e na fase 3 de 34 (28%) p< 0,001. Conclus??es: As t??cnicas de manuais de fisioterapia respirat??ria demonstraram gerar dor nos RNPT, entretanto, t??cnicas n??o farmacol??gicas como conten????o e glicose foram capazes de reduzi-la.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-20T19:48:50Z No. of bitstreams: 1 Andr?? Gustavo Moura Guimar??es.pdf: 1691381 bytes, checksum: b4f575802538a0af96f868e24171236c (MD5)Made available in DSpace on 2018-07-20T19:48:50Z (GMT). No. of bitstreams: 1 Andr?? 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dc.title.por.fl_str_mv Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
dc.title.alternative.eng.fl_str_mv Influence of neonatal pain and physiological variables through physiotherapeutic conditions in premature with respiratory distress syndrome in the intensive care unit
title Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
spellingShingle Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
Guimar??es, Andr?? Gustavo Moura
prematuro
s??ndrome do desconforto respirat??rio
dor neonatal
premature
respiratory distress syndrome
neonatal pain
CIENCIAS DA SAUDE
title_short Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
title_full Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
title_fullStr Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
title_full_unstemmed Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
title_sort Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva
author Guimar??es, Andr?? Gustavo Moura
author_facet Guimar??es, Andr?? Gustavo Moura
author_role author
dc.contributor.advisor1.fl_str_mv Lanza, Fernanda de Cordoba
dc.contributor.advisor-co1.fl_str_mv Saraty, Salma Brito
dc.contributor.referee1.fl_str_mv Lanza, Fernanda de Cordoba
dc.contributor.referee2.fl_str_mv Corso, Simone Dal
dc.contributor.referee3.fl_str_mv Jorge, Luciana Maria Malos?? Sampaio
dc.contributor.referee4.fl_str_mv Jos??, Anderson
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/7135874493191606
dc.contributor.author.fl_str_mv Guimar??es, Andr?? Gustavo Moura
contributor_str_mv Lanza, Fernanda de Cordoba
Saraty, Salma Brito
Lanza, Fernanda de Cordoba
Corso, Simone Dal
Jorge, Luciana Maria Malos?? Sampaio
Jos??, Anderson
dc.subject.por.fl_str_mv prematuro
s??ndrome do desconforto respirat??rio
dor neonatal
topic prematuro
s??ndrome do desconforto respirat??rio
dor neonatal
premature
respiratory distress syndrome
neonatal pain
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv premature
respiratory distress syndrome
neonatal pain
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Introduction: neonatal pain results in neurobiological effects, and changes in behavioral reactions of children who were born prematurely. There is no clear description about the pain caused by chest physiotherapy technique, nor about the possible non-pharmacological interventions to prevent it. Objective: to evaluate neonatal pain and physiological parameters during the chest physiotherapy in premature neonates (PTNB) in neonatal intensive care. Method: a randomized controlled trial, not blinded, in which 120 PTNB in mechanical ventilation were studied. They were randomized into four groups: control group (CG), diaphragmatic stimulation group (EDG), manual hyperinflation group (MHG), thoracic vibration group (VTG), containing 30 individuals in each one. The protocol consisted of 3 phases, the first phase being considered the control, and the other associated with non-pharmacological techniques to reduce pain: application of the technique (phase 1), application of technique + facilitated tucking (phase 2), application of technique + glucose (phase 3). Heart rate (HR), respiratory rate (RR), SpO2, Behavioral pain scale Indicators of Infant Pain (BIIP, ranges from 0 to 10) and Neonatal Infant Pain Scale (NIPS, ranges from 0 -7) were recorded at pre, during and after (15 minutes) the procedures described. Results: 62 (51.66%) RNPT were female, and most considered small for gestational age (83, 69%). Physiological variables (HR, FR, and SpO2) behaved in a similar manner in all groups (CG, MHG, EDG, VTG), being greater in phase 1, however these variables were reduced at phase 2 and 3 (p < 0.05). This means that during the application of non-pharmacological intervention (facilitated tucking or glucose) there was reduction of those variables. BIIP and NIPS scales showed increased in all of the groups in the phase 1 during the application of the techniques, however, similar to the physiological variables, these scales had reduced scores when applied to facilitated tucking (phase 2) or glucose (phase 3), p < 0.05. The number of individuals who have had pain assessed by BIIP (> 3 points) at the moment after in the phase 1 was 83 (69%), in phase 2 was 22 (18%), and in phase 3 of 34 (28%), p < 0.001. Conclusions: The chest physiotherapy techniques can increase the pain in PTNB, however, the non-pharmacological techniques, such as facilitated tucking and glucose, were able to reduce it.
publishDate 2018
dc.date.accessioned.fl_str_mv 2018-07-20T19:48:50Z
dc.date.issued.fl_str_mv 2018-03-06
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dc.identifier.citation.fl_str_mv Guimar??es, Andr?? Gustavo Moura. Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva. 2018. 114 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/1888
identifier_str_mv Guimar??es, Andr?? Gustavo Moura. Influ??ncia da dor neonatal e as vari??veis fisiol??gicas mediante as condutas fisioterap??uticas em prematuros com s??ndrome do desconforto respirat??rio na unidade de terapia intensiva. 2018. 114 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
url http://bibliotecatede.uninove.br/handle/tede/1888
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