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Epidemiology of painful procedures performed in neonates: A systematic review of observational studies
Author(s) -
Cruz M.D.,
Fernandes A.M.,
Oliveira C.R.
Publication year - 2016
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.757
Subject(s) - medicine , observational study , cinahl , context (archaeology) , neonatal intensive care unit , medline , epidemiology , intensive care , psychological intervention , pain assessment , population , venipuncture , intensive care medicine , critical appraisal , pain management , physical therapy , pediatrics , anesthesia , alternative medicine , nursing , paleontology , environmental health , pathology , political science , law , biology
Background and objective Procedural pain in neonates has been a concern in the last two decades. The purpose of this review was to provide a critical appraisal and a synthesis of the published epidemiological studies about procedural pain in neonates admitted to intensive care units. The aims were to determine the frequency of painful procedures and pain management interventions as well as to identify their predictors. Databases and data treatment Academic Search, CINAHL , LILACS , Medic Latina, MEDLINE and Sci ELO databases were searched for observational studies on procedural pain in neonates admitted to intensive care units. Studies in which neonatal data could not be extracted from the paediatric population were excluded. Results Eighteen studies were included in the review. Six studies with the same study duration, the first 14 days of the neonate life or admission in the unit of care, identified 6832 to 42,413 invasive procedures, with an average of 7.5–17.3 per neonate per day. The most frequent procedures were heel lance, suctioning, venepuncture and insertion of peripheral venous catheter. Pharmacological and nonpharmacological approaches were inconsistently applied. Predictors of the frequency of procedures and analgesic use included the neonate's clinical condition, day of unit stay, type of procedure, parental presence and pain assessment. The existence of pain protocols was not a predictor of analgesia. Conclusions Painful procedures were performed frequently and often with inadequate pain management. Unlike neonate clinical factors, organizational factors may be modified to promote a context of care more favourable to pain management.