The average number of procedures was 141 per baby. The type of procedure varied from a heel stick to draw blood to having to insert a chest tube.
Carbajal said there are numerous factors why neonates aren't receiving enough pain relief. One is a concern about side effects from pharmacological interventions; another is unfamiliarity with pain relief management for newborns and a lack of standardized policies in this setting. He also said that pharmaceutical companies haven't developed analgesic products especially for neonates.
He recommended that procedures be done in combination whenever possible, and that minor procedures should be accompanied by non-pharmacological pain-reducing methods, such as providing oral sucrose or glucose and sucking. He said topical anesthetics can be used to reduce pain from needle punctures, though it's not sufficient for heel stick pain. For major procedures, he said, analgesia in combination in non-pharmacological therapy is needed.
Carbajal said this study's findings would likely be similar in other areas of the world where neonatal intensive care is available.
"For most neonates who undergo any sort of painful procedure, it would be worthwhile to have a combination of pharmacological and non-pharmacological interventions," said Dr. Santhanam Suresh, an anesthesiologist at Children's Memorial Hospital in Chicago.
Carbajal added that parents can act as advocates for optimal pain management for their babies by asking the health-care team to use approaches that "limit the intensity, frequency or duration of pain."
To learn more about pain and pain relief for babies, read this information from the University of Michigan.
All rights reserved