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Newborns In ICUs Often Undergo Painful Procedures, Most Without Pain Medication

Posted Jul 07 2008 7:06pm

An examination of newborn intensive care finds that newborns undergo numerous procedures that are associated with pain and stress, and that many of these procedures are performed without medication or therapy to relieve pain, according to a new study.

“Repeated invasive procedures occur routinely in neonates [a baby, from birth to four weeks] who require intensive care, causing pain at a time when it is developmentally unexpected. Neonates are more sensitive to pain than older infants, children, and adults, and this hypersensitivity is exacerbated in preterm neonates. Multiple lines of evidence suggest that repeated and prolonged pain exposure alters their subsequent pain processing, long-term development, and behavior. It is essential, therefore, to prevent or treat pain in neonates,” the authors write. “Effective strategies to improve pain management in neonates require a better understanding of the epidemiology and management of procedural pain.”

Ricardo Carbajal, M.D., Ph.D., of the Hôpital d’enfants Armand Trousseau, Paris, and colleagues collected data on neonatal pain, based on direct bedside observations in intensive care units (ICUs) in the Paris region. The study, conducted between September 2005 and January 2006, included data on all painful and stressful procedures and corresponding analgesic (a medication used to relieve pain) therapy from the first 14 days of admission collected within a 6-week period from 430 neonates admitted to tertiary care centers. The average gestational age was 33 weeks, and the average intensive care unit stay was 8.4 days.

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