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Analgesic Techniques in Minor Painful Procedures in Neonatal Units: A Survey in Northern Italy
Author(s) -
Codipietro Luigi,
Bailo Elena,
Nangeroni Marco,
Ponzone Alberto,
Grazia Giuseppe
Publication year - 2011
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2010.00406.x
Subject(s) - medicine , analgesic , neonatal intensive care unit , intensive care , pain scale , pain assessment , pacifier , heel , anesthesia , breastfeeding , pain management , intensive care medicine , pediatrics , anatomy
The aim of this survey was to evaluate the current practice regarding pain assessment and pain management strategies adopted in commonly performed minor painful procedures in Northern Italian Neonatal Intensive Care Units (NICUs). Methods: A multicenter survey was conducted between 2008 and 2009 in 35 NICUs. The first part of the survey form covered pain assessment tools, the timing of analgesics, and the availability of written guidelines. A second section evaluated the analgesic strategies adopted in commonly performed painful procedures. The listed analgesic procedures were as follows: oral sweet solutions alone, non‐nutritive sucking (NNS) alone, a combination of sweet solutions and NNS, breast‐feeding where available, and topical anesthetics. Results: Completed questionnaires were returned from 30 neonatal units (85.7% response rate). Ten of the 30 NICUs reported using pain assessment tools for minor invasive procedures. Neonatal Infant Pain Scale was the most frequently used pain scale (60%). Twenty neonatal units had written guidelines directing pain management practices. The most frequently used procedures were pacifiers alone (69%), followed by sweet‐tasting solutions (58%). A 5% glucose solution was the most frequently utilized sweet‐tasting solution (76.7%). A minority of NICUs (16.7%) administered 12% sucrose solutions for analgesia and the application of topical anesthetics was found in 27% of NICUs while breast‐feeding was performed in 7% of NICUs. Discussion: This study found a low adherence to national and international guidelines for analgesia in minor procedures: the underuse of neonatal pain scales (33%), sucrose solution administration before heel lance (23.3%), topical anesthetics before venipuncture, or other analgesic techniques. The presence of written pain control guidelines in these regions of Northern Italy increased in recent years (from 25% to 66%).