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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.
Abstract:
Pain in newborn children should be prevented due to negative short- and long-term consequences. A good understanding of the development of the nociceptive system in newborns is necessary to enable optimal pain assessment, and most importantly to treat and prevent pain adequately in neonates. So far, preclinical juvenile animal studies have led to a tremendous amount of information regarding the development of the nociceptive system. In addition, they have made clear that the developmental stage of the nociceptive system may influence the mechanism of action of different classes of analgesics. Age specific analgesic therapy, based on post-menstrual age, should therefore be considered by incorporating information on the developmental stages of the nociceptive system in combination with knowledge from pharmacokinetic and -dynamic studies in neonates.
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