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. 2025 May 7;9(1):e003280.
doi: 10.1136/bmjpo-2024-003280.

Enhanced Recovery After Surgery (ERAS) consensus recommendations for non-pharmacological perioperative neonatal pain management

Brandon Pentz  1 , Kristin Short  2 , Mercedes Pilkington  3   4 , Tyara Marchand  5 , Saffa Aziz  5 , Jennifer Y Lam  6 , Adam Spencer  7 , Megan A Brockel  8 , Scott Else  7 , Duncan McLuckie  9 , Andrew Franklin  10 , David de Beer  11 , Mehul V Raval  12 , Michael Scott  13   14 , Mary E Brindle  4   15
Affiliations

Enhanced Recovery After Surgery (ERAS) consensus recommendations for non-pharmacological perioperative neonatal pain management

Brandon Pentz et al. BMJ Paediatr Open. .

Abstract

Enhanced Recovery After Surgery (ERAS) recommendations for multi-modal, opioid-limiting analgesia have been shown to be effective in paediatric patients. However, neonatal-specific protocols are limited, and protocols that address non-pharmacological approaches are rare. Through systematic review and modified Delphi consensus with anaesthesiologists, paediatric surgeons and researchers, we developed non-pharmacological recommendations to improve perioperative neonatal pain management. Evidence from 37 articles of variable quality informed these recommendations. Our consensus resulted in four recommendations: (1) use of sweet-tasting solutions, (2) non-nutritive sucking, (3) skin-to-skin and (4) music therapy. These recommendations aim to reduce neonatal opioid usage alongside pharmacological therapies. PROSPERO registration number: CRD42021265273.

Keywords: Analgesia; Neonatology.

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Conflict of interest statement

Competing interests: All authors were asked to declare any competing interests. There were no disclosed competing interests that influenced the guideline process of developing recommendations. MEB is on the Executive of the ERAS Society.

Figures

Figure 1
Figure 1. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram of study selection for non-pharmacological interventions.
See this image and copyright information in PMC

References

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