Pain management for necrotizing enterocolitis: getting the balance right

Area of Science:

• Neonatalogy
• Pediatric Surgery
• Pain Management

Background:

• Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease in preterm infants.
• Effective pain management is crucial to prevent negative short-term and long-term consequences of neonatal pain exposure.
• Current pain management strategies for NEC patients require evaluation.

Purpose of the Study:

• To describe current pain management practices for neonates with NEC.
• To assess the effectiveness of existing analgesic therapies in NEC patients.
• To identify areas for improvement in neonatal pain control during NEC.

Main Methods:

• Single-center, retrospective study design.
• Inclusion of neonates with NEC (Bell's stage II or III), born preterm (<32 weeks gestation and/or <1500g birth weight).
• Collection and analysis of pain scores (COMFORTneo, NRS) and analgesic administration during the acute disease period.

Main Results:

• 74% of 79 NEC patients received intravenous analgesics (morphine, fentanyl, acetaminophen).
• Median COMFORTneo score was 11, but 49 patients had scores ≥14, indicating pain.
• 19 patients experienced persistent high pain scores (≥14) for a median of 7.2 hours.

Conclusions:

• Despite analgesic therapy, most NEC patients exhibit signs of pain.
• Current pain management frequently fails to adequately control pain in NEC patients.
• There is an urgent need for individualized pain management guidelines for NEC.