Procedural pain management in neonates: A Narrative review

Abstract

Over the past three decades, awareness regarding pain management in neonates has risen significantly. It has been very well established that neonates can perceive, feel, and react to stimuli that cause pain and discomfort to them. Neonates admitted to neonatal intensive care units (NICUs) are repeatedly subjected to invasive treatments, most of which are painful. These procedures, nevertheless, are still performed, sometimes without sufficient analgesia. Exposure to frequent traumatic and painful procedures has been associated with several adverse effects such as altered brain growth and signs of internalization. Both inadequate and excessive analgesia during this period of rapid development may lead to profound neurodevelopmental outcomes. Ensuring the avoidance of pain in NICUs is a crucial obligation from both ethical and medical standpoints. Despite established international criteria, there is currently insufficient adherence to this criterion, highlighting the need for additional development in uniformly providing effective pain management to newborns in NICUs.

Keywords: Neonate; neonatal intensive care unit; pain; procedure; sedation.