Assessment and Management of Procedural Pain During the Entire Neonatal Intensive Care Unit Hospitalization

Painful procedures and pain management in newborns admitted to an intensive care unit

“…The results of this study, as well as other research in the Brazilian scenario (7,10,11) , demonstrate a high number of painful procedures and the scarcity of analgesic interventions. In Canadian NICUs, for instance, studies show a small number of procedures causing tissue damage, 5.8 procedures, on average, per week, with analgesia used in half of these procedures (24) and, more recently, an average of 1.75 procedure per day, by NB, and about 60% of the procedures were performed with some type of analgesia (2) . It can be said that the main barrier in Brazil is not the production of knowledge, but its translation aimed at applying knowledge in clinical practice, focusing on overcoming barriers (5) , which include, for example, the lack of access to reliable information in accessible language, lack of protocols and institutional guides, difficulty in incorporating new practices.…”

“…The Neonatal Intensive Care Unit (NICU) is, in general, a stress-causing environment, in which several factors can contribute to the newborn (NB) homeostasis disturbance (1) . Among these factors, the high amount of manipulations is highlighted, often being painful and stressful, due to clinical instability and the need to carry out invasive therapeutic and diagnostic procedures, such as tracheal intubation, blood collection, insertion of venous catheters, among other procedures (2) . Studies conducted in low, middle, and high income countries show that the average number of painful procedures performed during hospitalization in the NICU varies between 7.5 and 17.3 procedures per day (3) .…”

Pain management for infants – Myths, misconceptions, barriers; knowledge and knowledge gaps

“…Since this time there has been more than 100 further studies published reporting on analgesic effects of sweet solutions in newborns, which have been synthesised and included in systematic reviews (Harrison et al, 2017a;Huang et al, 2019;Stevens et al, 2016) including a systematic review of repeated doses of sweet solutions (Gao et al, 2016). Despite addressing myths and misconceptions of sweet solutions over 12 years ago, and despite the over-abundance of evidence of analgesic efficacy, ongoing studies of pain management practices continue to report inconsistent use of this effective, simple, safe, cost-effective evidence-based pain management strategy (Cruz et al, 2016;Harrison et al, 2018Harrison et al, , 2015Orovec et al, 2019). Since 2008, there has also been a growth of literature to support the parent-led pain management strategies of breastfeeding term medically stable newborns (Benoit et al, 2017), and skin-to-skin care in premature newborns (Johnston et al, 2017).…”

Culturally Based Practice in Neonatal Procedural Pain Management: A Mini Review

“…Neonates in neonatal intensive care units (NICUs) experience painful procedures, with a range between 7.5 and 17.3 per neonate per day (1); the most common procedures being heel lancing, suctioning, tape removal, nasogastric/orogastric tube insertion, intravenous line insertion, venipuncture, and peripherally inserted central catheter line insertion (2).…”