Developmental neurobiology as a guide for pharmacological management of pain in neonates

Nynke J van den Hoogen1, Anne R de Kort1, Karel M Allegaert2

  • 1Department of Anesthesiology and Pain Management, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Translational Neuroscience, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.

Insights

Preventing pain in newborns is crucial due to its lasting effects. Understanding the developing nociceptive system in neonates is key for effective pain management and treatment.

Area of Science:

  • Neonatal physiology
  • Neuroscience
  • Pain management

Background:

  • Pain in newborns has significant short- and long-term adverse effects.
  • Optimal pain assessment and treatment in neonates require understanding nociceptive system development.
  • Preclinical studies in juvenile animals provide substantial data on nociceptive system maturation.

Purpose of the Study:

  • To highlight the importance of understanding neonatal nociceptive system development.
  • To emphasize the influence of developmental stage on analgesic efficacy.
  • To advocate for age-specific analgesic therapy in neonates.

Main Methods:

  • Review of preclinical juvenile animal studies on nociceptive system development.
  • Analysis of how developmental stage impacts analgesic mechanisms.
  • Integration of pharmacokinetic and pharmacodynamic data in neonates.

Main Results:

  • The developmental stage of the nociceptive system influences analgesic mechanisms.
  • Preclinical studies offer valuable insights into nociceptive system development.
  • Pharmacokinetic and pharmacodynamic data are essential for neonatal analgesia.

Conclusions:

  • Age-specific analgesic therapy, based on post-menstrual age, is recommended for neonates.
  • Therapeutic strategies should combine knowledge of nociceptive system development with pharmacokinetic/pharmacodynamic data.
  • Adequate pain prevention and treatment in neonates are critical.

Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
718
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
553
Introduction to Developmental Psychology01:27

Introduction to Developmental Psychology

Developmental psychology explores the changes and continuities in human abilities throughout life, encompassing physical, cognitive, linguistic, and social dimensions. Human development is not restricted to growth, but includes aspects of decline, particularly in physical abilities as individuals age. Developmental psychologists seek to understand how people change as they age and how their mental and social skills evolve.Developmental MilestonesA key concept in developmental psychology is...
1.5K
Three Developmental Domains01:29

Three Developmental Domains

Human development is typically examined across three main domains: physical, cognitive, and socio-emotional. These domains represent the significant areas of change and continuity throughout the lifespan, from infancy to late adulthood.
Physical Development
Physical processes, also known as maturation, encompass the biological changes that occur across an individual's life. These changes begin with genetic inheritance and continue through various stages, including growth in height and weight,...
1.0K
Pain01:20

Pain

Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
1.3K