[Prevention and pain management in term and preterm infants]

Pain in the neonatal period is frequently experienced by 6-10% of newly born infants, preterm and term, who require neonatal intensive care. Repetitive painful procedures without adequate analgesia provided by the medical staff may bear long-term or even life-long adverse consequences. The use of pharmacological and non-pharmacological modalities in the management of pain may change this undesirable situation. The use of opioid analgesia for very painful procedures and the use of non-opioid medications in combination with opioids are essential. A change in the sensory environment of the sick infant is an important additional analgesic effect. In addition to pain management in the neonatal intensive care units, neonatal circumcision is the most frequent surgical procedure performed in males, and is frequently conducted without appropriate analgesia. The simple available methods of analgesia for neonatal circumcision are discussed and should be employed in order to avoid painful circumcision. Many pediatric medical associations in the developed world consider failure to provide proper routine analgesia for neonatal circumcision to be an unethical and sub-optimal medical practice.