Non-pharmacological management of infant and young child procedural pain

Riddell, Rebecca Pillai; Bucsea, Oana; Shiff, Ilana; Chow, Cheryl H. T.; Gennis, Hannah; Badovinac, Shaylea; Racine, Nicole; Kohut, Sara Ahola; Lisi, Diana; Turcotte, Kara; Stevens, Bonnie; Uman, Lindsay S.

doi:10.1002/14651858.cd006275.pub4

Cited by 4 publications

(3 citation statements)

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“…As a first step to overcome the current variations, we suggest that infants treated with LISA should receive non-pharmacologic interventions like swaddling and oral sucrose as these effectively reduce procedural pain. 22,23 In a second step, a standardized pain assessment could help identify infants who require additional pharmacologic analgosedation. This approach is feasible because LISA is typically not considered an emergency procedure.…”

Section: Discussionmentioning

confidence: 99%

Analgosedation for less‐invasive surfactant administration: Variations in practice

Muehlbacher,

Boos,

Geiger

et al. 2023

Pediatric Pulmonology

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BackgroundLess‐invasive surfactant administration (LISA) is widely used for surfactant delivery to spontaneously breathing preterm infants on nasal CPAP. However, the use of analgesia and/or sedation for the LISA procedure remains controversial.MethodsWe conducted a cross‐sectional survey of all tertiary neonatal intensive care units (NICUs) in Austria, Germany, and Switzerland to assess current practices of analgosedation for LISA in preterm infants.ResultsEighty‐eight of 172 (51.2%) NICUs responded to the survey, of which 83 (94.3%) perform LISA. Analgosedation for LISA is used in 60 (72.3%) NICUs. Twenty‐eight of those (46.7%) have unit protocols to guide analgosedation while 32 (53.3%) administer medication at the discretion of the attending physician. Ketamine (45.0% of NICUs), propofol (41.7%), fentanyl (21.7%), morphine (20.0%), and midazolam (20.0%) were most frequently used for analgosedation for LISA. Nine (10.7%) NICUs reported the use of pain or distress scores during LISA.ConclusionLISA is well established among tertiary NICUs in the German‐speaking countries. However, there are considerable variations regarding the use of analgosedation. More evidence is required to guide clinicians seeking to safely and effectively deliver surfactant via a thin catheter to spontaneously breathing preterm infants.

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Section: Discussionmentioning

confidence: 99%

Analgosedation for less‐invasive surfactant administration: Variations in practice

Muehlbacher,

Boos,

Geiger

et al. 2023

Pediatric Pulmonology

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“…Several reviews have demonstrated that parents can be part of the pain management for their infant ( 4 , 13 – 15 ) and that this is safe and effective ( 15 ). Some of the evaluated methods are almost solely performed by the mother (breastfeeding) or parent (SSC), whereas there are a number of methods that can be performed by the parents, other family members or health care professionals (e.g., facilitated tucking, providing non-nutritive sucking or swaddling) ( 16 ). There is moderate to high certainty evidence that skin-to-skin contact, and breastfeeding are effective pain-reducing methods, whereas other interventions should be seen as adjuvant or working best in combination with other ( 6 ).…”

Section: Reviewmentioning

confidence: 99%

Parent-led neonatal pain management—a narrative review and update of research and practices

Ullsten,

Campbell-Yeo,

Eriksson

2024

Front. Pain Res.

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IntroductionResearch related to parent-led neonatal pain management is increasing, as is the clinical implementation. Skin-to-skin contact, breastfeeding and parents' vocalizations are examples of pain reducing methods that give parents an opportunity to protect their infant from harm while alleviating their anxiety and developing their parenting skills.MethodsIn this paper we will provide a narrative review and describe the current research about parent-led neonatal pain management. Based on this we will discuss clinical challenges, implementation strategies and implications for future research.ResultsParents express great readiness to embrace opportunities to increase their self-efficacy in their ability to address infant pain. Parent-led pain-reducing methods are effective, feasible, cost-effective, culturally sensitive, and can be individualized and tailored to both the parent's and infant's needs. Both barriers and facilitators of parent-led pain care have been studied in research highlighting structural, organizational, educational, and intra- and interpersonal aspects. For example, health care professionals' attitudes and beliefs on parent-led methods, and their concern that parental presence during a procedure increases staff anxiety. On the other hand, the presence of a local pain champion whose duty is to facilitate the adoption of pain control measures and actively promote parent-professional collaboration, is crucial for culture change in neonatal pain management and nurses have a key role in this change. The knowledge-to-practice gap in parent-led management of infants' procedure-related pain highlight the need for broader educational applications and collaborative professional, parental and research initiatives to facilitate practice change.ConclusionParent-led neonatal pain management is more than simply a humane and compassionate thing to do. The inclusion of parent-led pain care has been scientifically proven to be one of the most effective ways to reduce pain associated with repeated painful procedures in early life and parents report a desire to participate. Focus on enablers across interprofessional, organizational and structural levels and implementation of recommended pediatric pain guidelines can support the provision of optimal evidence-based family-centered neonatal pain management.

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“…Worldwide, the treatment of acute and chronic pain is an unmet need in children and adolescents [ 1 , 2 ]. Health disparities, especially racial and ethnic disparities, have been identified in all fields of pediatric pain management, exacerbating the challenges in addressing this issue [ 3 ].…”

mentioning

confidence: 99%

The Silent Epidemic—Chronic Pain and Palliative Care Needs in Children and Adolescents

Zernikow

2024

Children

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Non-pharmacological management of infant and young child procedural pain

Cited by 4 publications

References 459 publications

Analgosedation for less‐invasive surfactant administration: Variations in practice

Analgosedation for less‐invasive surfactant administration: Variations in practice

Parent-led neonatal pain management—a narrative review and update of research and practices

The Silent Epidemic—Chronic Pain and Palliative Care Needs in Children and Adolescents

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