Topical anesthesia in neonates: clinical practices and practical considerations

Area of Science:

• Neonatal pain management
• Pharmacology
• Anesthesiology

Background:

• Limited options for neonatal pain prevention previously existed, primarily relying on lidocaine hydrochloride injections.
• Recent advancements have introduced various topical anesthetic formulations, including creams, gels, and a heat-activated patch.
• Lidocaine injection remains common for procedures like circumcision and lumbar puncture, but practical guidance on newer agents is lacking.

Purpose of the Study:

• To review and expand the available options for topical anesthesia in neonates.
• To provide practical information on the use of newer topical anesthetic agents in neonatal care.
• To address the growing need for effective pain management strategies in newborns undergoing procedures.

Main Methods:

• Literature review of topical anesthetic agents and their application in neonates.
• Analysis of available formulations: creams, gels, and patch systems.
• Evaluation of efficacy and safety data for neonatal pain prevention.

Main Results:

• A significant increase in the number and types of topical anesthetics has occurred over the last two decades.
• Newer agents offer alternatives to traditional lidocaine injections for neonatal pain control.
• Practical considerations for using these novel agents in neonates are discussed.

Conclusions:

• Topical anesthetics represent a valuable advancement in neonatal pain management.
• Expanded knowledge of newer agents can enhance pain prevention strategies for neonates undergoing procedures.
• Further research and clinical guidance are needed to optimize the use of these agents.