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Sedation and analgesia to facilitate mechanical ventilation
Michael E Nemergut1, Myron Yaster, Christopher E Colby
1Department of Anesthesiology, The Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. nemergut.michael@mayo.edu
Clinics in Perinatology
|August 27, 2013
Summary
Healthcare professionals must provide pain relief for all patients. This review examines sedation and analgesia for painful neonatal intensive care unit procedures, considering potential neurodevelopmental risks.
Area of Science:
- Neonatal medicine
- Pain management
- Neurodevelopmental research
Background:
- Pain management is an ethical imperative for healthcare professionals across all age groups.
- Neonates, especially premature and critically ill infants, have historically received inadequate pain treatment.
- Endotracheal intubation and mechanical ventilation are common, painful procedures in neonatal intensive care units (NICUs) often lacking adequate pain assessment and management.
Purpose of the Study:
- To review the current use of sedation and analgesia for facilitating endotracheal intubation and mechanical ventilation in neonates.
- To discuss the controversies surrounding potential adverse neurodevelopmental outcomes associated with sedative and anesthetic exposure in infants.
- To highlight the ethical and clinical implications of undertreating pain in this vulnerable population.
Main Methods:
- Literature review of studies on sedation and analgesia in neonatal intensive care.
- Analysis of data on the assessment and treatment of pain during endotracheal intubation and mechanical ventilation.
- Discussion of existing research on neurodevelopmental effects of anesthetic agents and pain exposure in neonates.
Main Results:
- Sedation and analgesia are frequently employed to manage pain during neonatal procedures like intubation and ventilation.
- There is ongoing debate regarding the long-term neurodevelopmental consequences of early-life exposure to sedatives and anesthetics.
- Failure to adequately treat pain in neonates presents significant ethical and clinical challenges.
Conclusions:
- Effective pain management, including appropriate sedation and analgesia, is crucial for neonates undergoing painful procedures.
- Further research is needed to fully understand and mitigate potential neurodevelopmental risks associated with neonatal sedation and analgesia.
- Balancing procedural necessity with pain prevention and minimizing potential adverse effects remains a critical focus in neonatal care.
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