A Guide to Pain Assessment and Management in the Neonate

Norina Witt, Seth Coynor, Christopher Edwards, Hans Bradshaw, Norina Witt, Seth Coynor, Christopher Edwards, Hans Bradshaw

Abstract

Newborn infants experience acute pain with various medical procedures. Evidence demonstrates that controlling pain in the newborn period is beneficial, improving physiologic, behavioral, and hormonal outcomes. Multiple validated scoring systems exist to assess pain in a neonate; however, there is no standardized or universal approach for pain management. Healthcare facilities should establish a neonatal pain control program. The first step is to minimize the total number of painful iatrogenic events when possible. If a procedure cannot be avoided, a tiered approach to manage pain using environmental, non-pharmacologic, and pharmacologic modalities is recommended. This systematic approach should decrease acute neonatal pain, poor outcomes, and provider and parent dissatisfaction.

Keywords: Acetaminophen; Breastfeeding; Fentanyl; Glucose and sucrose; Ketamine; Morphine; Neonatal; Pain management; Topical and local anesthetics.

Figures

Fig. 1
Fig. 1
A tiered approach to analgesia in the neonate

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