Year: 2017
Type: article
Study design: Observational Study
Abstract: 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 (NICUs) 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 NICUs 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.
Source: Acta Paediatrica
DOI: 10.1111/apa.13810
Authors: Kanwaljeet J. S. Anand, Mats Eriksson, Elaine M. Boyle, Alejandro Avila‐Alvarez, Randi Dovland Andersen, Kosmas Sarafidis, Tarja Polkki, Cristina Matos, Paola Lago, Thalia Papadouri, Simon Attard‐Montalto, Mari‐Liis Ilmoja, Sinno Simons, Rasa Tameliene, Bart van Overmeire, Angelika Berger, Anna Dobrzanska, Michael Schroth, Lena Bergqvist, Emilie Courtois, Jessica Rousseau, Ricardo Carbajal
Institutions: Stanford Medicine, Stanford University, Örebro University, University of Leicester, Complexo Hospitalario Universitario A Coruña, Telemark Hospital, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Oulu University Hospital, University of Padua, Archbishop Makarios III Hospital, Mater Dei Hospital, Erasmus MC - Sophia Children’s Hospital, Lithuanian University of Health Sciences, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Erasmus Hospital, Medical University of Vienna, Children's Memorial Health Institute, Cnopf´sche Kinderklinik, Karolinska Institutet, Inserm, Hôpital Armand-Trousseau, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Épidémiologie et Statistique, Université Pierre-et-Marie-Curie
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: Seventh Framework Programme
Award: G7799046314
OpenAlex ID: W2591849020