Development and Implementation of a Neonatal Pain Management Guideline for Minor Surgeries.

Area of Science:

• Neonatal intensive care
• Pediatric surgery
• Pain management

Background:

• Opioid analgesics are effective for neonatal postoperative pain but cumulative exposure can be harmful.
• Variability in provider practices highlights the need for standardized pain management protocols.
• Practice guidelines can promote consistency and reduce opioid utilization in neonates.

Purpose of the Study:

• To create a pain management guideline (PMG) for neonates undergoing minor surgical procedures.
• The primary goal was to decrease opioid use without negatively impacting pain management.
• To achieve at least 50% adherence to the PMG by neonatal intensive care unit providers.

Main Methods:

• An interdisciplinary workgroup developed an evidence-based PMG for minor surgical procedures.
• Providers and nurses received education on the new guideline.
• Rapid cycle quality improvement methods were used to refine interventions over three months.

Main Results:

• The PMG was implemented for 32 neonates undergoing minor surgery.
• Opioid use decreased by 88% compared to pre-guideline rates.
• Provider adherence to the PMG was approximately 83.3%.

Conclusions:

• A systematic PMG effectively guides the assessment, prevention, and treatment of neonatal pain post-minor surgery.
• This approach helps to alleviate the overuse of opioids in this population.
• Future research should address barriers to PMG implementation and extend guidelines to major surgical procedures.