Neonatal procedural pain management guidelines

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Neonatal pain management has made a great step forward over the last several years. Despite the drafting of International guidelines, an under-treatment of neonatal pain is still reported” Bellieni et al (2017).

Abstract:

PURPOSE: Neonatal pain management has made a great step forward over the last several years. Despite the drafting of International guidelines, an under-treatment of neonatal pain is still reported.

MATERIALS AND METHODS: Medical and paramedical personnel working in 5 Italian NICUs were asked to complete a questionnaire about pain management. The questionnaire was comprised of three sections: (i) brief explanation of the purpose; (ii) demographic information, including age, profession, religious beliefs, and hospital level; (iii) questionnaire about pain management and prevention.

RESULTS: One-hundred and forty caregivers participated in this study. Non-pharmacological analgesia during heel prick or venipuncture was used by 64% and 60% of them, respectively; topical analgesia was performed in 13% of venipunctures; no analgesia was used in 30% of cases for both heel prick and venipuncture. In the case of lumbar puncture, 35% of participants used topical analgesia, 15% non-pharmacological approach, 10% opioids and 6% intravenuous paracetamol. While 65% of participants gave a score of 4 out of 5 about the importance of pain treatment, 39% of them reported that in their department no pain scales were used.

CONCLUSIONS: Pain treatment in these NICUs is still far to be optimal. This nonetheless reflects a worldwide trend, which requires more attention on pain prevention, assessment and treatment.

Reference:

Bellieni, C.V., Tei, M., Cornacchione, S., Di Lucia, S., Nardi, V., Verrotti, A. and Buonocore, G. (2017) Pain perception in NICU: a pilot questionnaire. The Journal of Maternal-Fetal & Neonatal Medicine. May 17th. [Epub ahead of print].

doi: 10.1080/14767058.2017.1332038.

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