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Assessment of Continuous Pain in Newborns admitted to NICUs in 18 European Countries
Stanford University School of Medicine, Stanford, USA.
Örebro University, School of Health Sciences. Orebro University Hospital. (PEARL - Pain in Early Life)ORCID iD: 0000-0002-5996-2584
Department of Health Sciences, Leicester, United Kingdom .
Complexo Hospitalario Universitario de A Coruña, Coruña, Spain .
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

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 frequency of pain assessments, use of mechanical ventilation, sedation, analgesia, or neuromuscular blockade for each neonate upto 28 days after NICU admission.

Results: Only 2113/6648 (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 prompted (all p<0·01), and for newborns <32 weeks gestational age, those requiring ventilation, or opioids, sedatives-hypnotics, general anesthetics (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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017.
Keyword [en]
infant-newborn, infant-premature, suffering, NICU, clinical practices
National Category
Pediatrics
Research subject
Caring Sciences w. Medical Focus
Identifiers
URN: urn:nbn:se:oru:diva-56956DOI: 10.1111/apa.13810OAI: oai:DiVA.org:oru-56956DiVA: diva2:1086930
Projects
NeoopiodEUROPAIN - EUROpean-Pain-Audit-In-Neonates
Funder
EU, FP7, Seventh Framework Programme, 223767
Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2017-04-05Bibliographically approved

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CiteExportLink to record
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