정맥 천자 시 국소마취크림 도포가 아동의 통증에 미치는 효과
Effects of Topical Anesthetic Cream on Pain at Venipuncture in Children
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목적 본 연구는 아동의 정맥 천자 시 국소마취크림 도포가 통증에 미치는 효과를 규명하고자 시도하였다. 방법 경피적 국소마취크림 도포가 아동의 정맥 천자 시 통증에 미치는효과를 측정하기 위한 유사 실험 설계로 반복 측정연구이다. 경피적국소마취크림의 적용시간을 기존 1시간 적용보다 30분 단축한 30분으로 하였고, 대상자를 입원 시의 학령기 아동으로 하여 국소마취크림이정맥 천자 시 통증에 미치는 영향을 연구하였다. 정맥 천자 시 통증에대한 반응을 피부 전기반응, 아동의 자가 보고와 심박동수 측정으로조사하였다. 결과 정맥 천자 시 통증에 대한 피부 전기반응의 최대값과 평균값은 실험군이 대조군보다 유의하게 낮아 경피적 국소마취크림 도포가 정맥천자 시 아동의 통증을 감소시키는 효과가 있음을 알 수 있다. 결론 본 연구 결과 경피적 국소마취크림 도포가 아동의 정맥 천자 시 통증을 감소시키는 효과가 있었다. 또한 기존에 사용되던 통증의 생리적변수 이외에 피부 전도도(SCL)라는 변수를 통증반응의 지표로 측정하였고, 이는 통증의 새로운 지표를 아동의 통증 연구에 시도하였다는 데 의의가 있다. 아울러 아동의 경피적 국소마취크림의 적용 시간을 단축하여 향후 간호 실무에 도움을 줄 수 있을 것으로 생각된다.
Abstract
Purpose: This study was done to evaluate the effectiveness of EMLA cream on pain related to venipuncture among children. Methods: In thisstudy, 48 children were evaluated using a sequential measurement for level of pain by Skin Conductance Level (SCL) based on Galvanic SkinResponse (GSR), heart rate, and the Visual Analogue Scale (VAS) at four times. Results: The maximum and mean of the SCL were each significantlydifferent between the experimental and control groups and furthermore, the two were also significantly different among observed times. In addition there was a significant interaction between group and time. The children’s perceived pain using VAS was not significantly differentbetween the experimental and control groups. There was no significant difference in the heart rate between the experimental and controlgroups; however, the interaction between group and time was significant. Conclusion: In conclusion, applying topical anesthetic cream to thevenipuncture site to reduce pain was effective among the children and therefore it is highly recommended that topical anesthetic cream beapplied at the venipuncture site as a nursing intervention to reduce pain when a child has to undergo a venipuncture.
참고문헌 (26)
- Anand, K. J. S, "Pain and its effects in the human neonate and fetus", The New England Journal of Medicine, 317, pp.1321~1329 (1987)
- Borland, M. L, "Intranasal fentanyl reduces acute pain in children in the emergency department: A safety and efficacy study", Emergency Medicine, 14(3), pp.275~280 (2002)
- Bush, J. P, "Chronic pain: Clinical issues in health care management", pp.757~786 (1990), International Universities Press
- 정용선, "피부국소마취제가 아동의 정맥천자시 통증 경감과 불안 감소에 미치는 효과", Child Health Nursing Research, 12(2), pp.253~259 (2006), 한국아동간호학회
- Davidson, A, "Distress at induction: Prevention and consequences", Current Opinion in Anaesthesiology, 24(3), pp.301~306 (2011)
- Drendel, A. L, "Pain assessment for children: Overcoming challenges and optimizing care", Pediatric Emergency Care, 27(8), pp.773~781 (2011)
- Eichenfield, L. F, "A clinical study to evaluate the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics cream for pain reduction of venipuncture in children", Pediatrics, 109(6), pp.1093~1099 (2002)
- Fitzgerald, M, "Pain in infants, children, and adolescents", pp.11~31 (1993), Williams & Wilkins
- Harrison, D, "Skin conductance as a measure of pain and stress in hospitalised infants", Early Human Development, 82(9), pp.603~608 (2006)
- Hopkins, C, "Pain-free injection in infants", Anaesthesia, 43, pp.198~201 (1988)
- Kim, H. J, "The topical anesthesia with EMLA cream in children", The Korean Academy of Pediatric Dentistry, 29(1), pp.69~75 (2002)
- Koo, H. Y, "Uncertainty and anxiety in families of hospitalized children", Korean Journal of Child Health Nursing, 8(1), pp.67~76 (2003)
- Marco, C. A, "Self-reported pain scores in the emergency department : Lack of association with vital signs", Academic Emergency Medicine, 13(9), pp.974~979 (2006)
- Mathew, P. J, "Assessment and management of pain in infants", Postgraduate Medical Journal, 79(934), pp.438~443 (2003)
- Merskey, H, "Classification of chronic pain" (1994), IASP Press
- McMurtry, C. M, "Children’ fear during procedural pain: Preliminary investigation of the children’ fear scale", Health Psychology, 30(6), pp.780~788 (2011)
- Pereira-da-Silva, L, "Skin conductance indices discriminate nociceptive responses to acute stimuli from different heel prick procedures in infants", The Journal of Maternal-Fetal Medicine, 25(6), pp.796~801 (2012)
- Rogers, T. L, "The Use of EMLA cream to decrease venipuncture pain in children", ournal of Pediatric Nursing, 19(1), pp.33~39 (2004)
- Song, J. H, "Nursing Care of Children" (2011), Hyunmoonsa
- Sung, M. H, "A study on Health", Illness concepts in hospitalized preschoolers, 2000, pp.6(3), 291~304
- Taddio, A, "Effect of liposomal lidocaine and sucrose alone and in combination for venipuncture pain in newborns", Pediatrics, 127(4), pp.e940~e947 (2011)
- von Baeyer, C. L, "Children’ memory for pain: Overview and implications for practice", Journal of Pain, 5(5), pp.241~249 (2004)
- Yoon, Y. H, "Pain reduction at venipuncture in preterm infants : Oral glucose solution compared with EMLA cream and pacifiers", The Medical Journal of Chosun University, 29(2), pp.1~7 (2004)
- Young, S. S, "EMLA cream as a topical anesthetic before office phlebotomy in children", Southern Medical Journal, 89(12), pp.1184~1187 (1996)
- Zempsky, W. T, "Evaluation of a low-dose lidocaine iontophoresis system for topical anesthesia in adults and children : A randomized, controlled trial", Clinical Therapeutics, 26(7), pp.1110~1119 (2004)
- Zempsky, W. T, "Relief of pain and anxiety in pediatric patients in emergency medical systems", Pediatrics, 114(5), pp.1348~1356 (2004)