Non-pharmacological management of neonatal pain: Research and clinical practice in the Neonatal Intensive Care Unit

Linhares, Maria Beatriz Martins; Gaspardo, Cláudia Maria

doi:10.1590/1982-02752017000300003

Cited by 3 publications

(1 citation statement)

References 48 publications

(49 reference statements)

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“…Indeed, the nociceptive pathways and pain-signaling mechanisms are highly conserved in mammals. Thus, the central pain management is completely equivalent in rodents and other research species, such as cats, dogs, and primates, and it can be managed ( Linhares and Gaspardo, 2017 ). However, too few studies consider pain in the very young.…”

Section: Discussionmentioning

confidence: 99%

Long-Lasting Analgesia With Transdermal Fentanyl: A New Approach in Rat Neonatal Research

Dutriez-Casteloot

Emmanuelli

Wiart³

et al. 2022

Front. Pharmacol.

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Background: With advances in neonatal care, management of prolonged pain in newborns is a daily concern. In addition to ethical considerations, pain in early life would have long-term effects and consequences. However, its treatment remains inadequate. It was therefore important to develop an experimental model of long-lasting analgesia for neonatal research.Materials and Methods: Experiments were performed in six groups of rats with transdermal fentanyl 0, 3, 12, 50, 100, or 200 μg/kg/h from second postnatal day (P2) until weaning. Assessment of analgesia was carried out at P21, with behavioral scores (ranging from 0 to 3) using a 4% formalin test. Plasma levels of fentanyl were determined by UPLC/TQD at P22. Growth rate was investigated.Results: Fentanyl 100 and 200 μg/kg/h reduced scores of formalin-evoked behavioral pain. They increased time spent in pain score 0 (8 min 55 s and 6 min 34 s versus 23 s in controls) as in low pain scores 1 and 2, and decreased time in the most severe pain score 3 (19 min 56 s and 17 min 39 s versus 44 min 15 s). Fentanylemia increased in a dose-dependent manner from 50 μg/kg/h (2.36 ± 0.64 ng/ml) to 200 μg/kg/h (8.66 ± 1.80 ng/ml). Concerning growth, no difference was observed except weaker growth from P17 to P22 with 200 μg/kg/h. Clinically, we noticed no visible side effect from 3 to 100 μg/kg/h. Concomitantly, 200 μg/kg/h was responsible for ophthalmological side effects with appearance of corneal bilateral clouding in 90% pups. No difference was observed between male and female rats.Conclusion: Altogether, results indicate that transdermal fentanyl 100 μg/kg/h is an efficient therapeutic for long-lasting analgesia in lactating pups. This new model provides a useful tool for protection and welfare, and future opportunity for studying long-term health consequences of sustainable neonatal analgesia.

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Section: Discussionmentioning

confidence: 99%

Long-Lasting Analgesia With Transdermal Fentanyl: A New Approach in Rat Neonatal Research

Dutriez-Casteloot

Emmanuelli

Wiart³

et al. 2022

Front. Pharmacol.

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Interrelationships Between Health and Childhood Development: Research and Preventive Interventions at Early Ages

Linhares

2019

Psychology in Brazil

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Preterm Infant Care Practice among Nurses in Neonatal Care Units of Selected Hospitals of Nepal: A Cross-Sectional Study

Shrestha,

Bista,

Shrestha

et al. 2023

Nursing Forum

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Introduction. Preterm infants (PTIs) are vulnerable to morbidity, disability, and mortality. They require meticulous care for survival and development in neonatal care units (NCUs). PTI care in NCUs is a collaborative and team effort among different health professionals. However, nurses have a key role for quality care. This study aimed to assess nurses’ PTI care practices across different hospitals in Nepal. Methods. A descriptive cross-sectional study was conducted in NCUs of six randomly selected public hospitals in Nepal. After obtaining ethical approval, structured observation was completed among 40 NCU nurses using a practice checklist. After observation, a self-report questionnaire was administered among 102 nurses. Both descriptive and inferential statistics were used for data analysis. Results. The observation and self-reported mean infant care practices were 73.7% and 70.7%, respectively. The overall practice median score and the interquartile range (IQR) were 4.0 (3.5–4.3) with the highest score of (4.5 [4.1–4.7]) for daily supportive care and the lowest score of (2.8 [2.1–3.5]) for pain management. The care practice was strongly associated with the nurse-infant ratio (adjusted odd ratio (aOR) = 18.52, confidence interval (CI) = 5.83–58.77, and p=<0.001) and training status (aOR = 4.95, CI = 1.59–15.39, and p=0.006). Conclusion. Nurses have adequate practice of thermal care, safe oxygen administration, nutritional care, and infection prevention in NCUs, whereas lacking is found regarding developmental supportive care components (sleep promotion and a supportive sensory environment), parental support, and pain management practices. Consideration of the proper nurse-infant ratio and continued professional development opportunities are essential for practice enhancement in NCUs. These findings might be useful to identify the gaps in PTI care practice in NCUs.

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Non-pharmacological management of neonatal pain: Research and clinical practice in the Neonatal Intensive Care Unit

Cited by 3 publications

References 48 publications

Long-Lasting Analgesia With Transdermal Fentanyl: A New Approach in Rat Neonatal Research

Long-Lasting Analgesia With Transdermal Fentanyl: A New Approach in Rat Neonatal Research

Interrelationships Between Health and Childhood Development: Research and Preventive Interventions at Early Ages

Preterm Infant Care Practice among Nurses in Neonatal Care Units of Selected Hospitals of Nepal: A Cross-Sectional Study

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