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Assessment of continuous pain in newborns admitted to NICU s in 18 E uropean countries
Author(s) -
Anand Kanwaljeet J. S.,
Eriksson Mats,
Boyle Elaine M.,
AvilaAlvarez Alejandro,
Andersen Randi Dovland,
Sarafidis Kosmas,
Polkki Tarja,
Matos Cristina,
Lago Paola,
Papadouri Thalia,
AttardMontalto Simon,
Ilmoja MariLiis,
Simons Sinno,
Tameliene Rasa,
Overmeire Bart,
Berger Angelika,
Dobrzanska Anna,
Schroth Michael,
Bergqvist Lena,
Courtois Emilie,
Rousseau Jessica,
Carbajal Ricardo
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13810
Subject(s) - medicine , anesthesia , gestational age , mechanical ventilation , sedation , pain assessment , ventilation (architecture) , intensive care , propofol , odds ratio , prospective cohort study , pediatrics , pain management , intensive care medicine , surgery , pregnancy , mechanical engineering , genetics , engineering , biology
Aim Continuous pain occurs routinely, even after invasive procedures, or inflammation and surgery, but clinical practices associated with assessments of continuous pain remain unknown. Methods A prospective cohort study in 243 neonatal intensive care units ( NICU s) from 18 European countries recorded the frequency of pain assessments, use of mechanical ventilation, sedation, analgesia or neuromuscular blockade for each neonate for up to 28 days after NICU admission. Results Only 2113 of 6648 (31.8%) of neonates received assessments of continuous pain, occurring variably among tracheal ventilation (TrV, 46.0%), noninvasive ventilation (NiV, 35.0%) and no ventilation (NoV, 20.1%) groups (p < 0.001). Daily assessments for continuous pain occurred in only 10.4% of all neonates (TrV: 14.0%, NiV: 10.7%, NoV: 7.6%; p < 0.001). More frequent assessments of continuous pain occurred in NICU s with pain guidelines, nursing champions and surgical admissions (all p < 0.01), and for newborns <32 weeks gestational age, those requiring ventilation, or opioids, sedatives‐hypnotics, general anaesthetics (O– SH – GA ) (all p < 0.001), or surgery (p = 0.028). Use of O– SH – GA drugs increased the odds for pain assessment in the TrV ( OR :1.60, p < 0.001) and NiV groups ( OR :1.40, p < 0.001). Conclusion Assessments of continuous pain occurred in less than one‐third of NICU admissions and daily in only 10% of neonates. NICU clinical practices should consider including routine assessments of continuous pain in newborns.