Long-term consequences of pain in human neonates

Grunau, Ruth E.; Holsti, Liisa; Peters, Jeroen

doi:10.1016/j.siny.2006.02.007

Cited by 438 publications

(337 citation statements)

References 71 publications

Supporting

Mentioning

297

Contrasting

Unclassified

Order By: Relevance

“…With increased severity of pain, professional nurse respondents believed that the frequency of pharmacological pain management interventions should be increased. Moreover the respondents' ratings of procedural pain concur with empirical evidence on the painfulness of these procedures (Anand et al 1999;Granau et al 2006;Carbajal et al 2008;Johnston et al 2010).…”

Section: Discussionsupporting

confidence: 64%

Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

Khoza

Tjale

2014

curationis

View full text Add to dashboard Cite

Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice.Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals.Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng.Results: The response rate was 35.33% (n = 53), most respondents being professional nurses (88.68%; n = 47) working in neonatal intensive care units (80.77%; n = 42); 24 (45.28%) had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05) was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64%) reported that there were no pain management guidelines in the neonatal wards in which they worked.Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates.

show abstract

Section: Discussionsupporting

confidence: 64%

Knowledge, attitudes and practices of neonatal staff concerning neonatal pain management

Khoza

Tjale

2014

curationis

View full text Add to dashboard Cite

show abstract

“…These changes can be manifested by alterations in pain thresholds, stress responses, cognitive function, behavioral disorders, and long-term disabilities. 7,8 Despite this knowledge, many painful procedures in NICUs are performed without pharmacologic or nonpharmacologic analgesia. [1][2][3]9 Disadvantages of pharmacologic analgesia include side effects, questionable efficacy, and possible negative impact on neonatal outcomes.…”

mentioning

confidence: 99%

Oral Sucrose and “Facilitated Tucking” for Repeated Pain Relief in Preterms: A Randomized Controlled Trial

et al. 2012

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Preterm infants are exposed to inadequately managed painful procedures during their NICU stay, which can lead to altered pain responses. Nonpharmacologic approaches are established for the treatment of single painful procedures, but evidence for their effectiveness across time is lacking. WHAT THIS STUDY ADDS:Oral sucrose with or without the added technique of facilitated tucking has a pain-relieving effect even in extremely premature infants undergoing repeated pain exposures; facilitated tucking alone seems to be less effective for repeated pain exposures over time.abstract OBJECTIVES: To test the comparative effectiveness of 2 nonpharmacologic pain-relieving interventions administered alone or in combination across time for repeated heel sticks in preterm infants. METHODS:A multicenter randomized controlled trial in 3 NICUs in Switzerland compared the effectiveness of oral sucrose, facilitated tucking (FT), and a combination of both interventions in preterm infants between 24 and 32 weeks of gestation. Data were collected during the first 14 days of their NICU stay. Three phases (baseline, heel stick, recovery) of 5 heel stick procedures were videotaped for each infant. Four independent experienced nurses blinded to the heel stick phase rated 1055 video sequences presented in random order by using the Bernese Pain Scale for Neonates, a validated pain tool.RESULTS: Seventy-one infants were included in the study. Interrater reliability was high for the total Bernese Pain Scale for Neonates score (Cronbach' s a: 0.90-0.95). FT alone was significantly less effective in relieving repeated procedural pain (P , .002) than sucrose (0.2 mL/kg). FT in combination with sucrose seemed to have added value in the recovery phase with lower pain scores (P = .003) compared with both the single-treatment groups. There were no significant differences in pain responses across gestational ages.CONCLUSIONS: Sucrose with and without FT had pain-relieving effects even in preterm infants of ,32 weeks of gestation having repeated pain exposures. These interventions remained effective during repeated heel sticks across time. FT was not as effective and cannot be recommended as a nonpharmacologic pain relief intervention for repeated pain exposure.

show abstract

“…Table 1 below. 3 It is seen that the use of continuous analgesia prevailed among NB with pharmacologic analgesia, totaling 24 (80.0%). In the interval from the 24th and It is noticed that only 7 NB (23.3%) did not present pain in the assessment using the scale.…”

Section: Crossmentioning

confidence: 97%

“…It is also known that pain in the neonatal period may bring future results in motor, cognitive and affective response and it can cause changes in the pain threshold and in local sensibility (3) .…”

mentioning

confidence: 99%