虽然越来越多的证据表明新生儿期经历疼痛会对其后期的行为和神经系统发育造成不良影响,但至今对新生儿期疼痛是否需要干预存在争议。本指南制定组采用系统性综述、数据综合及开放式讨论达成的共识,形成全球性镇痛干预措施,包括药物、非药物、行为和环境方法来预防和控制新生儿操作性疼痛。目前,强有力证据已肯定蔗糖或母乳可减轻较弱的侵入性操作带来的疼痛,而气管插管则需联合药物止痛。然而,其他疼痛性操作(如留置或拔除胸导管,筛查或治疗早产儿视网膜病,或术后疼痛)控制措施则无文献支持,仅来源于临床实践或专家意见。 Although there is growing evidence that pain experienced during the neonatal period can have adverse effects on later behavior and neurological development, it is controversial to date whether there is any need for intervention in neonatal pain. The guideline development group used systematic reviews, data synthesis and consensus reached in an open discussion to create global pain-relieving interventions that include drug, non-drug, behavioral and environmental approaches to prevent and control neonatal operative pain. Currently, there is strong evidence that sucrose or breast milk can reduce the pain associated with weaker invasive procedures, whereas intubation requires combination analgesics. However, other pain management practices, such as indwelling or removing the thoracic duct, screening or treating retinopathy of prematurity or postoperative pain, are not supported by literature, but only from clinical practice or from expert opinion.