Background: 

Removal of a chest tube is a painful procedure for infants. Medications, including narcotics, are used to control pain, but nonpharmacologic interventions are also effective in reducing pain during this procedure and are not associated with adverse effects.

Purpose: 

To evaluate the additive effect of facilitated tucking to the use of morphine on infant pain associated at the time of chest tube removal.

Methods: 

This was a prospective, randomized control study. Sixty infants were randomized into 2 equal groups utilizing a coin flip. All infants received 0.05-mg/kg morphine 20 minutes before chest tube removal. The intervention group received facilitated tucking and the control group received standard care. Infant pain was measured using the Neonatal Infant Pain Scale. Pain was assessed at 3 time points by 2 independent evaluators: 5 minutes before, during, and 5 minutes after removal of the chest tube. Mann-Whitney and Fisher's exact (Chi-square) tests were used to compare the intervention and control groups.

Results: 

Pain scores were increased during chest tube removal for both the intervention and the control groups. Compared with the control group, pain scores for infants in the intervention group were less before, during, and after chest tube removal.

Implications for Practice: 

Facilitated tucking combined with morphine administration can be an effective additive intervention for pain control in infants during chest tube removal.

Implications for Research: 

Evaluate the effect of the facilitated tucking on pain induced by chest tube removal in preterm infants. Preterm infants may respond differently to pain.

中文翻译：

---

易化褶皱对婴儿胸管移除引起的疼痛强度的影响

背景： 

移除胸管对婴儿来说是一个痛苦的过程。包括麻醉剂在内的药物用于控制疼痛，但非药物干预也可有效减轻该过程中的疼痛，并且与不良反应无关。

目的： 

评估促进褶皱和使用吗啡对移除胸管时婴儿疼痛的附加影响。

方法： 

这是一项前瞻性随机对照研究。60 名婴儿通过抛硬币随机分为 2 个相等的组。所有婴儿在取出胸管前 20 分钟接受 0.05 mg/kg 吗啡。干预组接受便利的褶皱，对照组接受标准护理。使用新生儿婴儿疼痛量表测量婴儿疼痛。由 2 名独立评估员在 3 个时间点评估疼痛：胸管移除前 5 分钟、移除期间和移除后 5 分钟。Mann-Whitney 和 Fisher 的精确（卡方）检验用于比较干预组和对照组。

结果： 

干预组和对照组的胸管拔除期间疼痛评分均有所增加。与对照组相比，干预组婴儿在拔除胸管之前、之中和之后的疼痛评分均较低。

实践意义： 

促进褶皱联合吗啡给药可以作为一种有效的附加干预措施，用于控制婴儿在胸管移除期间的疼痛。

研究意义： 

评估促进褶皱对早产儿胸管移除引起的疼痛的影响。早产儿对疼痛的反应可能不同。