Pharmacological approaches to the management of pain in the neonatal intensive care unit

Anand, K.J.S.

doi:10.1038/sj.jp.7211712

Cited by 103 publications

(96 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with international standards for the adequate pain management of moderate to severe pain (Anand 2007;Lago et al 2009). Nursing studies addressing neonatal pain management support the implementation of non-pharmacological interventions, particularly with prevention and alleviation of neonatal procedural pain (Halimaa et al 2001;Spence et al 2010;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

“…98 A systematic review in 2012 found insufficient evidence to recommend midazolam infusions for sedation in the NICU and raised safety concerns, particularly regarding neurotoxicity. 97 Alternative medications, such as methadone, 99 ketamine, propofol, and dexmedetomidine, have been proposed for pain management in neonates; however, few, if any, studies of these agents have been performed in this population, and caution should be exercised when considering them for use because of concerns about unanticipated adverse effects and potential neurotoxic effects. 100 Although the potential benefits of using methadone for the treatment of neonatal pain include satisfactory analgesic effects and enteral bioavailability as well as prolonged duration of action related to its long half-life and lower expense compared with other opiates, safe and effective dosing regimens have yet to be developed.…”

Section: Opioids Benzodiazepines and Other Drugsmentioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

319

171

View full text Add to dashboard Cite

The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures. Therefore, every health care facility caring for neonates should implement (1) a pain-prevention program that includes strategies for minimizing the number of painful procedures performed and (2) a pain assessment and management plan that includes routine assessment of pain, pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimizing pain associated with surgery and other major procedures.

show abstract

“…Methadone was chosen as the opioid of choice because of its excellent oral bioavailability (70%-100%) and long half-life (19-41 hours), which allowed for long intervals between doses. 148 In this initial report, 3 symptomatic patients who had been exposed to continuous or bolus opioids for up to 7 weeks were transitioned to a methadone regimen of 0.1 mg/kg, orally, every 12 hours. Dose reduction by 10% to 20% of the initial dose per week resulted in successful weaning in 4 to 6 weeks.…”

Section: Management Of Acquired Opioid and Benzodiazepine Dependencymentioning

confidence: 99%

Neonatal Drug Withdrawal

Hudak¹,

Tan²,

Frattarelli³

et al. 2012

Pediatrics

740

608

View full text Add to dashboard Cite

Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.

show abstract

Pharmacological approaches to the management of pain in the neonatal intensive care unit

Cited by 103 publications

References 51 publications

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

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

Prevention and Management of Procedural Pain in the Neonate: An Update

Neonatal Drug Withdrawal

Contact Info

Product

Resources

About