Assessment and Management of Pain and Distress in the Neonate

Abstract

Pain management is an integral focus of neonatal care. This article reviews the physiology and impact of neonatal pain and distress and pain assessment tools, as well as clinical interventions and current controversies in the management of pain and distress in neonates. Current guidelines to enhance the recognition and treatment of pain are highlighted.

Guide to Capillary Heelstick Blood Sampling in Infants

“…[19][20][21][22][23] Studies used a range of sucrose concentrations and doses. [19][20][21][22][23] Studies used a range of sucrose concentrations and doses.…”

“…21,23,27 Maintaining containment during and after procedures reduces stress. 21 (4) avoiding previous areas that may be infected. 21 (4) avoiding previous areas that may be infected.…”

The Combined Use of Sucrose and Nonnutritive Sucking for Procedural Pain in Both Term and Preterm Neonates

“…1,3,5 There are conflicting data as to the long-term effects repeated painful stimuli as a neonate. This instability alters metabolic demand and oxygenation and may contribute to intraventricular hemorrhage.…”

“…In the older preterm and full-term neonates, pain and distress, in the short term, can manifest itself in sleep and feeding disruptions and disruptions in interaction patterns. 1,2,4,5,7 Although these agents have been extensively studied, there is a gap in knowledge as to the appropriate dosing of sucrose and in the safety and efficacy of long-term repeated doses of sucrose. Some older infants and children have exaggerated responses to painful stimuli, while others have decreased responses.…”

“…1,3,4 There are multiple lines of evidence showing that neonates who are hospitalized undergo multiple painful procedures during their stay. [1][2][3]5 However, newborns have been shown to exhibit a more prolonged stress response than adults as measured by an increase in cortisol. These procedures are medically necessary for their care but may become quite extensive.…”