Related Experiment Video

Updated: May 23, 2025

A Preterm Rat Model for Pain Studies
01:37

A Preterm Rat Model for Pain Studies

Published on: February 9, 2024

293

Enhanced Recovery After Surgery (ERAS) consensus recommendations for non-pharmacological perioperative neonatal pain

Brandon Pentz1, Kristin Short2, Mercedes Pilkington3,4

  • 1Surgery, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada Brandon.Pentz@ucalgary.ca.

BMJ Paediatrics Open
|May 9, 2025
PubMed

Insights

New guidelines offer non-pharmacological pain management strategies for newborns undergoing surgery. These methods, including sweet solutions and skin-to-skin contact, aim to reduce opioid use in neonatal Enhanced Recovery After Surgery (ERAS) protocols.

Area of Science:

  • Neonatal care
  • Pain management
  • Surgical recovery

Background:

  • Limited neonatal-specific protocols exist for Enhanced Recovery After Surgery (ERAS), particularly those incorporating non-pharmacological pain management.
  • Existing ERAS guidelines for pediatric patients focus on multi-modal, opioid-limiting analgesia but lack neonatal specificity.
  • There is a need for evidence-based, non-pharmacological approaches to improve perioperative pain management in neonates.

Discussion:

  • Developed through systematic review and modified Delphi consensus, these recommendations address the gap in neonatal pain management.
  • The consensus involved anaesthesiologists, pediatric surgeons, and researchers to ensure comprehensive and expert-driven guidelines.
  • Evidence from 37 articles, despite variable quality, informed the consensus on effective non-pharmacological interventions.

Key Insights:

  • Four key non-pharmacological recommendations were established: sweet-tasting solutions, non-nutritive sucking, skin-to-skin contact, and music therapy.
  • These interventions are designed to complement pharmacological therapies, offering a multi-modal approach to neonatal analgesia.
  • The primary goal is to reduce reliance on opioids in the perioperative period for neonates.

Outlook:

  • These recommendations provide a foundation for developing standardized neonatal ERAS protocols.
  • Further research may explore the comparative effectiveness and optimal integration of these non-pharmacological methods.
  • Implementation of these strategies has the potential to significantly improve neonatal surgical outcomes and reduce opioid-related adverse events.

Keywords:
AnalgesiaNeonatology

More Related Videos

Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography06:29

Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography

Published on: November 29, 2017

6.5K
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP14:56

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

Published on: January 27, 2010

21.3K

Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
405
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
39
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
183
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...
420
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
203