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Guidelines for procedural pain in the newborn
Author(s) -
Lago Paola,
Garetti Elisabetta,
Merazzi Daniele,
Pieragostini Luisa,
Ancora Gina,
Pirelli Anna,
Bellieni Carlo Valerio
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01291.x
Subject(s) - medicine , intensive care medicine , analgesic , scientific evidence , clinical practice , intubation , best evidence , acute pain , evidence based practice , evidence based medicine , anesthesia , physical therapy , alternative medicine , philosophy , epistemology , pathology
Abstract Despite accumulating evidence that procedural pain experienced by newborn infants may have acute and even long‐term detrimental effects on their subsequent behaviour and neurological outcome, pain control and prevention remain controversial issues. Our aim was to develop guidelines based on evidence and clinical practice for preventing and controlling neonatal procedural pain in the light of the evidence‐based recommendations contained in the SIGN classification. A panel of expert neonatologists used systematic review, data synthesis and open discussion to reach a consensus on the level of evidence supported by the literature or customs in clinical practice and to describe a global analgesic management, considering pharmacological, non‐pharmacological, behavioural and environmental measures for each invasive procedure. There is strong evidence to support some analgesic measures, e.g. sucrose or breast milk for minor invasive procedures, and combinations of drugs for tracheal intubation. Many other pain control measures used during chest tube placement and removal, screening and treatment for ROP, or for postoperative pain, are still based not on evidence, but on good practice or expert opinions. Conclusion: These guidelines should help improving the health care professional's awareness of the need to adequately manage procedural pain in neonates, based on the strongest evidence currently available.