Application of White Noise in Neonatal Peripheral Venipuncture Pain
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摘要:
目的 分析白噪声干预在新生儿外周静脉穿刺疼痛中的应用效果。 方法 选取云南省某医院儿科新生儿重症监护室2022年9月至2022年11月住院新生儿135例，按随机数字表法分为白噪声组、古典音乐组和对照组各45例，进行外周静脉穿刺时分别播放白噪声、古典音乐，对照组采用常规轻拍安抚干预。比较3组新生儿的疼痛评估量表得分、心率、啼哭时间等结局指标。 结果 白噪声组、古典音乐组外周静脉穿刺时及穿刺后30 s、60 s、90 s、120 s的疼痛评分较对照组明显降低，差异均有统计学意义（P < 0.05）；白噪声组外周静脉穿刺时、穿刺后60 s及90 s的疼痛评分低于古典音乐组（P < 0.05）；外周静脉穿刺时及穿刺后30 s、60 s、90 s、120 s的心率，白噪声组、古典音乐组较对照组明显降低（P < 0.05）；白噪声组外周静脉穿刺后30 s、60 s、90 s的心率低于古典音乐组（P < 0.05）；白噪声组、古典音乐组外周静脉穿刺时新生儿啼哭时间较对照组缩短（P < 0.05）；白噪声组外周静脉穿刺时新生儿啼哭时间短于古典音乐组（P < 0.05）。 结论 白噪声可以有效缓解新生儿外周静脉穿刺时的疼痛并缩短啼哭时间，推荐应用到新生儿疼痛管理。 Abstract:Objective To analyze the effect of white noise intervention in neonatal peripheral venipuncture pain. Methods A total of 135 hospitalized neonates from September 2022 to November 2022 in the Pediatric Newborn Intensive Care Unit of a hospital in Yunnan Province were included. They were randomly divided into a white noise group, a classical music group and a control group, with 45 cases in each group according to a random number table. White noise and classical music were played during peripheral venipuncture, while the control group was treated with routine tapping and pacifying intervention. Neonatal pain assessment score, heart rate, crying time and other outcome indicators were compared among the three groups. Results Compared with the control group, the pain scores at the time of peripheral venipuncture and 30 s, 60 s, 90 s and 120 s after venipuncture in the white noise group and the classical music group were significantly reduced and the differences were statistically significant （P < 0.05）. The pain scores at the time of peripheral venipuncture, 60 s and 90 s after puncture in the white noise group were lower than those in the classical music group （P < 0.05）. The heart rates at 30 s, 60 s, 90 s and 120 s after peripheral venipuncture in the white noise group and the classical music group were significantly lower than those in the control group （P < 0.05）. The heart rates of 30 s, 60 s and 90 s after peripheral venipuncture in the white noise group were lower than those in the classical music group （P < 0.05）. The neonatal crying time during peripheral vein puncture in the white noise group and the classical music group was shorter than that in the control group （P < 0.05）. The neonatal crying time during peripheral venipuncture in the white noise group was shorter than that in the classical music group （P < 0.05）. Conclusion White noise can effectively relieve pain and shorten crying time in neonatal peripheral venous puncture, and it is recommended to be applied to neonatal pain management. -
Key words:
- White noise /
- Venipuncture /
- Pain /
- Neonate /
- Classical music
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表 1 新生儿一般资料比较[n（%）/M（P25，P75）]
Table 1. Comparison of general data of newborns [n（%）/M（P25，P75）]
组别 白噪声组（n = 45） 古典音乐组 对照组（n = 45） χ2/ H P 性别 0.770 0.680 男 21（46.3） 22（48.9） 25（55.6） 女 24（53.3） 23（51.1） 20（44.4） 胎龄（周） 38.00（37.50，39.00） 38.00（37.00，39.00） 38.00（37.00，39.00） 1.824 0.402 入院日龄（d） 1.00（1.00，4.00） 1.00（1.00，4.00） 2.00（1.00，4.50） 2.305 0.316 出生体质量（g） 3300.00（3000.00，3680.00） 3200.00（2815.00，3500.00） 3260.00（2825.00，3500.00） 1.806 0.405 出生方式 0.798 0.671 顺产 29（64.4） 25（55.6） 26（57.8） 剖宫产 16（35.6） 20（44.4） 19（42.2） 1minApgar评分 10.00（8.00，10.00） 9.00（8.00，10.00） 10.00（8.50，10.00） 2.956 0.228 
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表 2 新生儿疼痛评分比较（
$\bar x \pm s $ ）Table 2. Comparison of neonatal pain scores （
$\bar x \pm s $ ）组别 外周静脉穿刺时 外周静脉穿刺后 30 s 60 s 90 s 120 s 白噪声组（n = 45） 5.53 ± 1.04#△ 4.76 ± 0.77# 3.16 ± 0.80#△ 2.13 ± 0.73#△ 0.98 ± 0.70# 古典音乐组（n = 45） 5.67 ± 0.79# 4.93 ± 0.89# 3.62 ± 0.83# 2.69 ± 0.66# 0.80 ± 0.88# 对照组（n = 45） 6.13 ± 0.79 5.20 ± 1.16 4.02 ± 0.94 2.80 ± 0.92 1.29 ± 0.79 F 7.882 5.463 11.466 9.710 5.395 P 0.001* 0.005* < 0.001* < 0.001* 0.006* *P < 0.05；与对照组比较，#P < 0.05；与古典音乐组比较，△P < 0.05。
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表 3 新生儿心率比较（
$\bar x \pm s $ ）Table 3. Comparison of neonatal heart rate （
$\bar x \pm s $ ）组别 外周静脉穿刺
前2 min外周静脉
穿刺时外周静脉穿刺后 30 s 60 s 90 s 120 s 白噪声组（n = 45） 137.67 ± 9.62 173.38 ± 3.21# 161.47 ± 2.67#△ 148.18 ± 4.20#△ 146.78 ± 3.04#△ 140.42 ± 1.79# 古典音乐组（n = 45） 137.80 ± 7.95 173.91 ± 2.19# 163.58 ± 3.16# 154.91 ± 5.80# 149.16 ± 1.46# 142.64 ± 4.08# 对照组（n = 45） 139.40 ± 8.08 175.98 ± 4.09 166.22 ± 2.75 161.22 ± 2.10 152.53 ± 4.13 148.38 ± 1.44 F 0.568 7.983 31.112 103.257 39.722 103.841 P 0.568 0.001* < 0.001* < 0.001* < 0.001* < 0.001* *P < 0.05；与对照组比较，# P < 0.05；与古典音乐组比较，△P < 0.05。
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表 4 新生儿啼哭时间比较（
$\bar x \pm s $ ）Table 4. Comparison of neonatal crying time（
$\bar x \pm s $ ）组别 啼哭时间（s） 白噪声组（n = 45） 58.96 ± 3.59# △ 古典音乐组（n = 45） 62.76 ± 7.60# 对照组（n = 45） 72.27 ± 2.76 F 81.205 P < 0.001* *P < 0.05；与对照组比较，# P < 0.05；与古典音乐组比较，△P < 0.05。
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