Turkish Neonatal Society guideline on the neonatal pain and its management

Şule Yiğit, Ayşe Ecevit, Özge Altun Köroğlu, Şule Yiğit, Ayşe Ecevit, Özge Altun Köroğlu

Abstract

Pain control is an important ethical issue to be considered and constitutes the basis of treatment in premature and term newborns. The inadequacy of pain control in these infants in neonatal intensive care units leads to neurodevelopmental and behavioral problems in the long term. For this reason, it is extremely important to raise awareness of the presence of pain in newborn infants, to reduce invasive procedures applied to infants as much as possible, and to minimize pain with non-pharmacologic or pharmacologic treatments when it is inevitable.

Keywords: Newborn; pain; treatment.

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Morphine tapering guideline Written: 06/15/09 Sarah Tierney Pharm D, Julie Lindower MD, MPH &Stephanie Stewart RN, MSN; Updated: 11/17/09, 3/12/2012 Jonathan Klein, MD and Sarah Tierney, Pharm D, University of Iowa Children’s Hospital, NeonatologyTextbook

References

    1. Anand KJS, Hicley PR. Pain and its effects in the human neonate and fetus. NEJM. 1987;317:1321–9.
    1. Hardman MP, Manning N, Hall RW, Anand KJ, Clancy B. Neurodevelopmental changes of fetal pain. Semin Perinatol. 2007;31:275–82.
    1. Giannakoulopoulos X, Sepulveda W, Kourtis P, Glover V, Fisk NM. Fetal plasma cortisol and beta-endorphin response to intrauterine needling. Lancet. 1994;344:77–81.
    1. Van Howe RS, Svoboda JS. Neonatal pain relief and the Helsinki Declaration. J Law Med Ethics. 2008;36:803–23.
    1. Alinejad-Naeini M, Mohagheghi P, Peyrovi H, Mehran A. The effect of facilitated tucking during endotracheal suctioning on procedural pain in preterm neonates: a randomized controlled crossover study. Glob J Health Sci. 2014;6:278.
    1. Bruce E, Franck L, Howard RF. The efficacy of morphine and Entonox analgesia during chest drain removal in children. Paediatr Anaesth. 2006;16:302–8.
    1. American Academy of Pediatrics Committee on Fetus and Newborn, American Academy of Pediatrics Section on Surgery, Canadian Paediatric Society Fetus and Newborn Committee. Batton DG, Barrington KJ, Wallman C. Prevention and management of pain in the neonate: an update. Pediatrics. 2006;118:2231.
    1. Maxwell LG, Malavolta CP, Fraga MV. Assessment of pain in the neonate. Clin Perinatol. 2013;40:457–69.
    1. Fabrizi L, Slater R, Worley A, et al. A shift in sensory processing that enables the developing human brain to discriminate touch from pain. Curr Biol. 2011;21:1552–8.
    1. Hummel P, Puchalski M, Creech SD, Weiss MG. Clinical reliability and validity of the N-PASS: neonatal pain, agitation and sedation scale with prolonged pain. J Perinatol. 2007;28:55–60.
    1. Valkenburg AJ, Boerlage AA, Ista E, Duivenvoorden HJ, Tibboel D, van Dijk M. The COMFORT-behavior scale is useful to assess pain and distress in 0- to 3-year-old children with Down syndrome. Pain. 2011;152:2059–64.
    1. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV Pain Study Group of the Italian Society of Neonatology. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009;98:932–9.
    1. Franck LS, Lawhon G. Environmental and behavioral strategies to prevent and manage neonatal pain. Semin Perinatol. 1998;22:434–43.
    1. Pillai Riddell RR, Racine NM, Turcotte K, et al. Nonpharmacological management of infant and young child procedural pain. Cochrane Database Syst Rev. 2011:CD006275.
    1. Shah PS, Herbozo C, Aliwalas LL, Shah VS. Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database Syst Rev. 2012;12:CD004950.
    1. Sahoo JP, Rao S, Nesargi S, Ranjit T, Ashok C, Bhat S. Expressed breast milk vs 25% dextrose in procedural pain in neonates, a double blind randomized controlled trial. Indian Pediatr. 2013;50:203–7.
    1. Ou-Yang MC, Chen IL, Chen CC, Chung MY, Chen FS, Huang HC. Expressed breast milk for procedural pain in preterm neonates: a randomized, double-blind, placebocontrolled trial. Acta Paediatr. 2013;102:15–21.
    1. Rosali L, Nesargi S, Mathew S, Vasu U, Rao SP, Bhat S. Efficacy of expressed breast milk in reducing pain during ROP screening--a randomized controlled trial. J Trop Pediatr. 2015;61:135–8.
    1. McNair C, Campbell Yeo M, Johnston C, Taddio A. Nonpharmacological management of pain during common needle puncture procedures in infants: current research evidence and practical considerations. Clin Perinatol. 2013;40:493–508.
    1. Harrison D, Bueno M, Yamada J, Adams-Webber T, Stevens B. Analgesic effects of sweet-tasting solutions for infants: current state of equipoise. Pediatrics. 2010;126:894–902.
    1. Gal P, Kissling GE, Young WO, et al. Efficacy of sucrose to reduce pain in premature infants during eye examinations for retinopathy of prematurity. Ann Pharmacother. 2005;39:1029–33.
    1. Stevens B, Yamada J, Lee GY, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2013;1:CD001069.
    1. Bellieni CV, Stazzoni G, Tei M, et al. How painful is a heelprick or a venipuncture in a newborn? J Matern Fetal Neonatal Med. 2016;29:202–6.
    1. Bueno M, Yamada J, Harrison D, et al. A systematic review and meta-analyses of nonsucrose sweet solutions for pain relief in neonates. Pain Res Manag. 2013;18:153–61.
    1. Johnston CC, Filion F, Snider L, et al. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks'postconceptional age. Pediatrics. 2002;110:523–8.
    1. Stevens B, Yamada J, Beyene J, et al. Consistent management of repeated procedural pain with sucrose in preterm neonates: Is it effective and safe for repeated use over time? Clin J Pain. 2005;21:543–8.
    1. Holsti L, Grunau RE. Considerations for using sucrose to reduce procedural pain in preterm infants. Pediatrics. 2010;125:1042–7.
    1. Hui-Chen F, Hsiu-Lin C, Shun-Line C, et al. The effect of EMLA cream on minimizing pain during venipuncture in premature infants. J Trop Pediatr. 2013;59:72–3.
    1. Lemyre B, Hogan DL, Gaboury I, et al. How effective is tetracaine 4% gel, before a venipuncture, in reducing procedural pain in infants: a randomized doubleblind placebo controlled trial. BMC Pediatr. 2007;7:7.
    1. Taddio A, Lee CM, Parvez B, et al. Contact dermatitis and bradycardia in a preterm infant given tetracaine 4% gel. Ther Drug Monit. 2006;28:291–4.
    1. Schmidt B, Adelmann C, Stutzer H, et al. Comparison of sufentanil versus fentanyl in ventilated term neonates. Klin Padiatr. 2010;222:62–6.
    1. Saarenmaa E, Huttunen P, Leppaluoto J, et al. Alfentanil as procedural pain relief in newborn infants. Arch Dis Child Fetal Neonatal Ed. 1996;75:F103–7.
    1. Silva YP, Gomez RS, Marcatto Jde O, et al. Early awakening and extubation with remifentanil in ventilated premature neonates. Paediatr Anaesth. 2008;18:176–83.
    1. Alencar AJ, Sanudo A, Sampaio VM, et al. Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates. Arch Dis Child Fetal Neonatal Ed. 2012;97:F24–9.
    1. Menon G, Boyle EM, Bergqvist LL, et al. Morphine analgesia and gastrointestinal morbidity in preterm infants: secondary results from the NEOPAIN trial. Arch Dis Child Fetal Neonatal Ed. 2008;93:F362–7.
    1. Fahnenstich H, Steffan J, Kau N, et al. Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000;28:836–9.
    1. Finnegan LP. Neonatal abstinence syndrome: assessment and pharmacotherapy. In: Nelson N, editor. Current therapy in neonatal-perinatal medicine. 2 ed. Ontario: BC Decker; 1990.
    1. Berkenbosch JW, Tobias JD. Development of bradycardia during sedation with dexmedetomidine in an infant concurrently receiving digoxin. Pediatr Crit Care Med. 2003;4:203–5.
    1. Chrysostomou C, Schulman SR, Herrera Castellanos M, et al. A phase II/III, multicenter, safety, efficacy, and pharmacokinetic study of dexmedetomidine in preterm and term neonates. J Pediatr. 2014;164:276–82.
    1. van den Anker JN, Tibboel D. Pain relief in neonates: when to use intravenous paracetamol. Arch Dis Child. 2011;96:573–4.
    1. Ohlsson A, Shah PS. Paracetamol (acetaminophen) for prevention or treatment of pain in newborns. Cochrane Database Syst Rev. 2015;6:CD011219.
    1. Allegaert K, Vanhole C, de Hoon J, et al. Nonselective cyclo-oxygenase inhibitors and glomerular filtration rate in preterm neonates. Pediatr Nephrol. 2005;20:1557–61.
    1. Betremieux P, Carre P, Pladys P, et al. Doppler ultrasound assessment of the effects of ketamine on neonatal cerebral circulation. Dev Pharmacol Ther. 1993;20:9–13.
    1. Saarenmaa E, Neuvonen PJ, Huttunen P, et al. Ketamine for procedural pain relief in newborn infants. Arch Dis Child Fetal Neonatal Ed. 2001;85:F53–6.
    1. Yan J, Jiang H. Dual effects of ketamine: neurotoxicity versus neuroprotection in anesthesia for the developing brain. J Neurosurg Anesthesiol. 2014;26:155–60.
    1. Welzing L, Kribs A, Eifinger F, et al. Propofol as an induction agent for endotracheal intubation can cause significant arterial hypotension in preterm neonates. Paediatr Anaesth. 2010;20:605–11.
    1. Litman RS, Soin K, Salam A. Chloral hydrate sedation in term and preterm infants: an analysis of efficacy and complications. Anesth Analg. 2010;110:739–46.
    1. Ng E, Taddio A, Ohlsson A. Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit. Cochrane Database Syst Rev. 2012:CD002052.
    1. Simons SH, van Dijk M, van Lingen RA, et al. Routine morphine infusion in preterm newborns who received ventilatory support: a randomized controlled trial. JAMA. 2003;290:2419–27.
    1. Anand KJ, Hall RW, Desai N, et al. Effects of morphine analgesia in ventilated preterm neonates: primary outcomes from the NEOPAIN randomized trial. Lancet. 2004;363:1673–82.
    1. Hall RW, Anand KJ. Pain management in newborns. Clin Perinatol. 2014;41:895–924.

Source: PubMed

3
Se inscrever