Assessment and Management of Pain in Preterm Infants: A Practice Update

Campbell‐Yeo, Marsha; Eriksson, Mats; Benoit, Britney

doi:10.3390/children9020244

Cited by 70 publications

(40 citation statements)

References 181 publications

(169 reference statements)

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“…Non-nutritive and or sucrose/glucose suckling are well studied and established methods that are helpful [ 98 ] albeit for mild pain [ 94 ]. Breastfeeding especially direct, has been found to be the best practice in non-pharmacological pain management [ 61 ], compared all other methods [ 76 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ]. A tiered approach to pain management is advisable dictated by the procedure to be performed [ 121 ].…”

Section: Discussionmentioning

confidence: 99%

“…Direct-breastfeeding is the direct suckling on the breast regardless of the delivery of milk to the infant [ 106 ], while expressed breast feeding is the extraction and storage of milk for later delivery with a bottle [ 107 ]. Direct breastfeeding is the unequivocal best practice in non-pharmacological pain management methods since it has been compared to all other methods and has been found more effective [ 61 ]. It fared much better compared to swaddling [ 76 , 86 ], maternal holding [ 87 ] or skin-to-skin care [ 88 , 89 ], topical anesthetics [ 90 ] and cooling sprays [ 91 ], non-nutritive sucking [ 92 ] and music [ 93 ] in pain management.…”

Section: Non-pharmacological Methodsmentioning

confidence: 99%

“…Up to now, more than 40 pain rating scales for neonates in NICU have been published [ 58 , 61 ]. They are a mainstay as they help us not only quantify pain, but can provide an accurate depiction of the impact of pharmacological and non-pharmacological pain management interventions in a neonate.…”

Section: Pain Scalesmentioning

confidence: 99%

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Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants

et al. 2022

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Neonates do experience pain and its management is necessary in order to prevent long-term, as well as, short-term effects. The most common source of pain in the neonatal intensive care unit (NICU) is caused by medically invasive procedures. NICU patients have to endure trauma, medical adhesive related skin injuries, heel lance, venipuncture and intramuscular injection as well as nasogastric catheterization besides surgery. A cornerstone in pain assessment is the use of scales such as COMFORT, PIPP-R, NIPS and N-PASS. This narrative review provides an up to date account of neonate pain management used in NICUs worldwide focusing on non-pharmacological methods. Non-steroidal anti-inflammatory drugs have well established adverse side effects and opioids are addictive thus pharmacological methods should be avoided if possible at least for mild pain management. Non-pharmacological interventions, particularly breastfeeding and non-nutritive sucking as primary strategies for pain management in neonates are useful strategies to consider. The best non-pharmacological methods are breastfeeding followed by non-nutritive sucking coupled with sucrose sucking. Regrettably most parents used only physical methods and should be trained and involved for best results. Further research in NICU is essential as the developmental knowledge changes and neonate physiology is further uncovered together with its connection to pain.

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Section: Discussionmentioning

confidence: 99%

Section: Non-pharmacological Methodsmentioning

confidence: 99%

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Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants

et al. 2022

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“…In Egypt, preterm birth problems are responsible for 38% of infant mortality (Hamad et al, 2022). Premature newborns in Neonatal Intensive Care Unit (NICU) are frequently exposed to several painful but necessary medical diagnostic and therapeutic procedures (Campbell-Yeo et al, 2022).…”

Section: Neonatesmentioning

confidence: 99%

The effect of facilitated tucking position on premature outcomes and pain intensity induced by invasive procedure in premature

Diab

2023

Egyptian Journal of Health Care

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Background: Premature neonates are vulnerable humans requiring much care and attention. pain experience in neonatal period leads to short-and long-term complications that could be prevented by means of neonatal pain relief. Aim: To assess the effect of facilitated tucking position on premature outcomes and pain intensity induced by invasive procedure in premature. Methods: Researcher conducted a quasi-experimental research design at neonatal intensive care units at Benha Children's Specialized Hospital. A purposive sample of premature neonates were randomly divided into two groups: control and study, each with 34 premature neonates. Researcher collected the data through neonatal characteristics, Vital signs sheet, Premature neonates pain profile, neonatal behavioral state. Results: The study revealed that 64.4% and 35.6% of study group had mild and moderate pain, while 48.9% and 8.9% of control group had moderate and sever pain post invasive procedure. Also, mean of quiet sleep of premature neonates in study group was 16.03±3.78, while in control group was 7.33±2.92, at p value 0.005**. Conclusion: Facilitated tucking position had significantly decreasing the severity of pain compared to control group. Also, the current results mentioned that, less than two thirds of study premature neonates had mild pain, while about half of them at control group suffered from moderate pain. In addition, facilitated tucking position decrease change in heart rate and oxygen saturation. Moreover, increase time of quiet and active sleep, while decrease time of active alert and crying among premature neonates Recommendation: Facilitated tucking position should be a part of the routine care for all premature admitted to NICUs. An illustrated leaflet demonstrating step by step about facilitated tucking position should be available at neonatal intensive care units. Continuous training program about facilitated tucking position should implement regularly.

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“…Бензодіазепіни належать до класу препаратів, яких слід уникати у недоношених новонароджених на штучній вентиляції легень через значний ризик важкого внутрішньошлуночкового крововиливу, перивентрикулярної лейкомаляції або смерті [18]. Ці гострі побічні ефекти можуть бути спричинені транзиторною гіпотензією та зниженням середньої швидкості церебрального кровотоку, пов'язаної з болюсними дозами у недоношених новонароджених [19]. Доклінічні дослідження також показали нейроапоптоз і тривалий функціональний дефіцит після раннього впливу сибазону [20].…”

Section: результати та їх обговоренняunclassified

Anesthesia or Sedation of Newborns in Intensive Care: How to Determine the Optimal Way?

Tsvirenko¹,

Tarasenko²,

Adamchuk³

et al. 2022

Act. Probl. of the Modern Med.

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During their stay in the intensive care unit, newborns are subjected to an enormous number of painful procedures and operations. Poorly treated pain during the newborn period can lead to negative remote effects such as cognitive dysfunction, the formation of chronic pain. Therefore, every day reanimatologists accept the challenge to evaluate the pain adequately and to choose right analgesia tactics. The literature review represents the analysis of 87 literary sources over the past 10 years. This article covers the results of multicenter studies and clinical recommendations. It has been determined that optimal treatment of pain and anxiety in newborns requires a multimodal approach, always including non-medication strategies and directed primarily to analgesia. Placing on the chest and breastfeeding, sucking reflex, «skin to skin» contact, «kangaroo» care, swaddling – all these aspects of childcare are effective to reduce physiological and behavioural response to pain in invasive procedures, and also have sedative effect. Every manipulation requires a mandatory analgesic. The choice of the method of anesthesia depends on the invasiveness of the procedure, gestational age and the severity of the condition of the child. It is advisable to combine various non-medication analgesic methods for mild pain, to add medication methods for moderate and severe pain to achieve better therapeutic effect. Neonates who are on prolonged ventilation cannot avoid sedation. However, sedation can be achieved by a combination of non-medication methods and sedatives. In order to prevent tachyphylaxis, analgesics should be rotated, and combinations of opiates with non-narcotic analgesics and adjuvant analgesics should be used. The multimodal approach to pain treatment has the benefits of reducing the dosage of any single drug and mitigating the overall risk of side effects. Acetaminophen, fentanyl or morphine in combination with midazolam are the safest medicines for use in newborns, despite the side effects.

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Assessment and Management of Pain in Preterm Infants: A Practice Update

Cited by 70 publications

References 181 publications

Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants

Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants

The effect of facilitated tucking position on premature outcomes and pain intensity induced by invasive procedure in premature

Anesthesia or Sedation of Newborns in Intensive Care: How to Determine the Optimal Way?

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