Neonatal pain

The articles by Harrison et al. and Gray et al.1 in this issue of the Journal tell an unfortunately familiar story. Despite the increasing evidence that pain has potentially negative consequences if untreated and thewealth of available data on how to treat it, pain in neonates is often ignored. These papers are the latest in a long line that highlight the disparity between what we know and what we do regarding pain in the newborn period.2–5 This disparity, however, is not unique to the management of pain in fragile newborns but is evident in the painmanagement of essentially everyone. John Bonica, an anaesthesiologist who was an early pioneer in the treatment of pain, wrote in 1990, ‘For nearly thirty years I have studied the reasons for inadequate management of postoperative pain and they remain the same . . . inadequate or improper application of available information and therapies is certainly the most important reason for inadequate postoperative pain relief’.6