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Prevention and Management of Procedural Pain in the Neonate: An Update

    Pediatrics
    |January 27, 2016
    PubMed

    Insights

    Preventing pain in newborns is crucial, especially for premature infants in the NICU who face numerous painful procedures. Proven therapies for neonatal pain management are underused and should be implemented in all facilities.

    Area of Science:

    • Neonatal care
    • Pediatric pain management

    Background:

    • Repeated painful exposures in neonates can lead to neurodevelopmental impairment.
    • Premature infants, particularly the smallest and sickest, experience the most pain in the NICU.
    • There are significant knowledge gaps in optimal neonatal pain prevention and relief strategies.

    Purpose of the Study:

    • To emphasize the ethical imperative and clinical necessity of neonatal pain prevention.
    • To highlight the underutilization of existing, safe, and effective pain management therapies for neonates.
    • To advocate for the implementation of comprehensive pain management programs in neonatal care settings.

    Main Methods:

    • Review of current practices and knowledge gaps in neonatal pain management.
    • Identification of ethical considerations and potential consequences of unrelieved neonatal pain.
    • Proposal of a two-part pain management program for healthcare facilities.

    Main Results:

    • Proven, safe therapies for neonatal pain are underused for routine procedures.
    • Neonates at highest risk for neurodevelopmental impairment are exposed to the most painful stimuli.
    • Effective pain prevention strategies are essential for vulnerable infants.

    Conclusions:

    • Healthcare facilities must implement pain prevention programs to minimize painful procedures.
    • A robust pain assessment and management plan, including pharmacologic and nonpharmacologic therapies, is necessary.
    • Systematic implementation of pain management protocols is vital for improving neonatal outcomes.

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