Pain management in hospitalized neonates: Extended literature review
Manejo de dolor en neonatos hospitalizados: Revisión ampliada de la literatura
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Romero, H., García, C. A., & Galindo, J. P. (2015). Pain management in hospitalized neonates: Extended literature review. Journal of Medicine and Surgery Repertoire, 24(3), 182–193. https://doi.org/10.31260/RepertMedCir.v24.n3.2015.614
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Abstract
Background: Patients hospitalized in the newborn unit are exposed to manipulations and medical procedures that can cause pain (even if this is not evident), stress and disturbance of wakefulness, being preterm a vulnerable group. Not receiving adequate treatment or in a timely manner, as well as being under the presence of pain, causes metabolic and systemic changes related to the release of hormones associated with stress, leading to being more susceptible to infections due to low immune system response. Methodology: systematic search in databases OVID, MDConsult, HINARI, PUBMED, THE COCHRANE LIBRARY, UPTODATE and EMBASE, with Mesh terms in different combinations, as well as DeCS terms. Articles in English and Spanish that were not published more than ten years ago were reviewed. In some, a snowball search was conducted. Conclusions: there are pharmacological measures or not with evidence for pain management in procedures that are carried out in the neonatal intensive care unit; they should be put into practice and use scales that adequately assess the presence of pain in the newborn. Abbreviations: RN, newborn (s); NICU, neonatal intensive care unit.
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References
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2. Maxwell LG, Malavolta CP, Fraga MV. Assessment of pain in the neonate. Clin Perinatol. 2013;40(3):457-69.
3. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009;98(6):932-9.
4. Martínez-Tellería A, Delgado JA, Cano ME, Núñez J, Gálvez R. Analgesia postoperatoria en el neonato. Rev Soc Esp Dolor. 2002; 9:317-27.
5. Lago P, Garetti E, Boccuzzo G, Merazzi D, Pirelli A, Pieragostini L, et al. Procedural pain in neonates: the state of the art in the implementation of national guidelines in Italy. Pediatr Anesth. 2013; 23(5):407-14.
6. Guedj R, Danan C, Daoud P, Zupan V, Renolleau S, Zana E, et al. Does neonatal pain management in intensive care units differ between night and day? An observational study. BMJ open. 2014;4(2):e004086.
7. Ranger M, Grunau RE. Early repetitive pain in preterm infants in relation to the developing brain. Pain Manag. 2014;4(1): 57-67.
8. Grunau RE. Neonatal pain in very preterm infants: long-term effects on brain, neurodevelopment and pain Reactivity. Rambam Maimonides Med J. 2013 Oct 29;4(4):e0025.
9. Rodrigues AC, Guinsburg R. Pain evaluation after a non-nociceptive stimulus in preterm infants during the first 28days of life. Early Hum Dev. 2013;89(2):75-9.
10. Walker SM. Biological and neurodevelopmental implications of neonatal pain. Clin Perinatol. 2013; 40(3):471-91.
11. Vinall J, Miller SP, Chau V, Brummelte S, Synnes AR, Grunau RE. Neonatal pain in relation to postnatal growth in infants born very preterm. Pain. 2012;153(7):1374-81.
12. Consideraciones generales sobre dolor. En: Sociedad Venezolana de Puericultura y Pediatría. Dolor en pediatría. Caracas: Médica Panamericana; 2010. p. 16.
13. Mayock DE, Gleason CA. Pain and sedation in the NICU. NeoReviews. 2013;14(1): e22-31.
14. Holsti L, Grunau RE, Oberlander TF, Osiovich H. Is it painful or not? Discriminant validity of the Behavioral Indicators of Infant Pain (BIIP) scale. Clin J Pain. 2008 Jan;24(1):83-8.
15. Narbona López E, Contreras Chova F, García Iglesias F, Miras Baldo MJ. Manejo del dolor en el recién nacido. En: Asociación Española de Pediatría. Protocolos diagnósticos terapeúticos de la AEP: neonatología [monografía en Internet]. Madrid, España: AEP; 2008. [citado 15 Jul 2015]. Disponible en: http://www.aeped.es/sites/default/files/documentos/49.pdf. 36. Taddio A, Ohlsson A, Einarson TR, Stevens B, Koren G. A systematic review of lidocaine-prilocaine cream (EMLA) in the treatment of acute pain in neonates. Pediatrics. 1998;101(2):E1. 37.
16. Taylor BJ, Robbins JM, Gold JI, Logsdon TR, Bird T, Anand K. Assessing postoperative pain in neonates: a multicenter observational study. Pediatrics. 2006;118(4):e992-e1000.
17. Codipietro L, Bailo E, Nangeroni M, Ponzone A, Grazia G. Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy. Pain Prac. 2011;11(2):154-9.
18. an Dijk M, Peters JW, van Deventer P, Tibboel D. The COMFORT Behavior Scale: a tool for assessing pain and sedation in infants. Am J Nurs. 2005 Jan; 105(1):33-6.
19. Ozawa M, Yokoo K. Pain management of neonatal intensive care units in Japan. Acta Paediatr. 2013;102(4):366-72.
20. Shah V, Ohlsson A. Venepuncture versus heel lance for blood sampling in term neonates. The Cochrane database of systematic reviews. 2001(2):CD001452.
21. Franck LS, Oulton K, Nderitu S, Lim M, Fang S, Kaiser A. Parent involvement in pain management for NICU infants: a randomized controlled trial. Pediatrics. 2011 Sep; 128(3):510-8.
22. Allegaert K, Tibboel D. Shouldn’t we reconsider procedural techniques to prevent neonatal pain?. Eur J Pain. 2007;11(8):910-2.
23. American Academic of Pediatrics. Committee on Fetus Newborn. Section on Surgery, Canadian Paediatric Society. Fetus Newborn Committee. Prevention and management of pain in the neonate: an update. Pediatrics. 2006. 118(5): 2231-41.
24. Kumar P, Denson SE, Mancuso TJ. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010 Mar;125(3):608-15.
25. Harrison D, Beggs S, Stevens B. Sucrose for procedural pain management in infants. Pediatrics. 2012;130(5): 918-25.
26. Batton DG, Barrington KJ, Wallman C. Prevention and management of pain in the neonate: an update. Pediatrics. 2006 Nov; 118(5): 2231-41.
27. Campbell-Yeo M, Johnston C, Benoit B, Latimer M, Vincer M, Walker D, Streiner D, Inglis D, Caddell K. Trial of repeated analgesia with Kangaroo Mother Care. BMC pediatrics. 2013;13(1):182.
28. Scottish Intercollegiate Guidelines Network. SIGN 50: a guideline developer’s handbook [monograph on the Internet]. Edinburgh: SIGN; 2014. [cited 2014 Nov 14]. Available in: http://www.sign.ac.uk/pdf/sign50.pdf
29. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #23: Non-pharmacologic management of procedure-related pain in the breastfeeding infant. Breastfeed Med. 2010 Dec; 5(6):315-9.
30. Shah V, Ohlsson A. Venepuncture versus heel lance for blood sampling in term neonates. Cochrane Database Syst Rev. 2007 Oct 17; (4):CD001452.
31. Barker D, Willetts B, Cappendijk V, Rutter N. Capillary blood sampling: should the heel be warmed?. Arch Dis Child Fetal Neonatal Ed.1996;74(2):F139-40.
32. Johnston C, Campbell-Yeo M, Rich B, Whitley J, Filion F, Cogan J, et al. Therapeutic touch is not therapeutic for procedural pain in very preterm neonates: a randomized trial. Clin J Pain. 2013; 29(9):824-9.
33. Johnston C, Campbell-Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skinto-skin care for procedural pain in neonates. Cochrane Database Syst Rev. 2014; (1): CD008435.
34. O’Brien L, Taddio A, Lyszkiewicz DA, Koren G. A critical review of the topical local anesthetic amethocaine (Ametop) for pediatric pain. Pediatr Drugs. 2005;7(1):41-54.
35. Bonetto G, Salvatico E, Várela N, Cometto C, Gómez PF, Calvo B. Prevención del dolor en recién nacidos de término: estudio aleatorizado sobre tres métodos. Rev Soc Bol Ped. 2010; 49(2):108-13.
36. Taddio A, Ohlsson A, Einarson TR, Stevens B, Koren G. A systematic review of lidocaine-prilocaine cream (EMLA) in the treatment of acute pain in neonates. Pediatrics. 1998;101(2):E1.
37. Kluger N, Raison Peyron N, Michot C, Guillot B, Bessis D. Acute bullous irritant contact dermatitis caused by EMLA® cream. Contact Dermatitis. 2011;65(3):181-2.
38. Spence K, Henderson Smart D, New K, Evans C, Whitelaw J, Woolnough R. Evidenced based clinical practice guideline for management of newborn pain. J Paediatr Child Health. 2010;46(4):184-92.
39. Taddio A, Soin HK, Schuh S, Koren G, Scolnik D. Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: a randomized controlled trial. CMAJ. 2005;172(13):1691-5.
40. Taddio A, Shah V, Stephens D, Parvez E, Hogan M-E, Kikuta A, Koren G, Katz J. Effect of liposomal lidocaine and sucrose alone and in combination for venipuncture pain in newborns. Pediatrics. 2011;127(4):e940-7.
41. Niño A, Cristo J. Abordaje del dolor en el recién nacido. Guía de práctica clínica [monografía en Internet]. Bogotá: Universidad Militar Nueva Granada; 2014. [citado 17 Jul 2015]. Disponible en: http://repository.unimilitar.edu.co/bitstream/10654/10763/3/Ni%C3%B1oAdaVirginia2013.pdf
42. Yamada J, Stinson J, Lamba J, Dickson A, McGrath PJ, Stevens B. A review of systematic reviews on pain interventions in hospitalized infants. Pain Res Manag. 2008 Sep-Oct;13(5):413-20.
43. Walker S. Neonatal Pain. Paediatr Anaesth. 2014 Jan; 24(1): 39-48.
44. Ng E, Taddio A, Ohlsson A. Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit. Cochrane Database Syst Rev. 2012 Jun 13; 6: CD002052.
45. Harrison D, Beggs S, Stevens B. Sucrose for procedural pain management in infants. Pediatrics. 2012 Nov; 130(5): 918-25.
46. Wong C, Lau E, Palozzi L, Campbell F. Pain management in children: Part 1—Pain assessment tools and a brief review of nonpharmacological and pharmacological treatment options. Can Pharm J (Ott). 2012;145(5):222-5.
47. Anand K, McIntosh N, Lagercrantz H, Pelausa E, Young TE, Vasa R. Analgesia and sedation in preterm neonates who require ventilatory support: results from the NOPAIN trial. Arch Pediatr Adolesc Med. 1999;153(4):331-8.
48. Attarian S, Tran LC, Moore A, Stanton G, Meyer E, Moore RP. The neurodevelopmental impact of neonatal morphine administration. Brain Sci. 2014; 4(2): 321-34.
49. Storch De Gracia Calvo P, De La Torre Espí M, Martín Díaz M, García Ruiz S, Domínguez Ortega G, Novoa Carballal R, editors. ¿Se realiza correctamente la punción lumbar en pediatría?. Revisión de las recomendaciones actuales y análisis de la realidad. An Pediatr (Barc). 2012; 77(2): 115-23.
50. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009 Jun; 98(6): 932-9.
2. Maxwell LG, Malavolta CP, Fraga MV. Assessment of pain in the neonate. Clin Perinatol. 2013;40(3):457-69.
3. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009;98(6):932-9.
4. Martínez-Tellería A, Delgado JA, Cano ME, Núñez J, Gálvez R. Analgesia postoperatoria en el neonato. Rev Soc Esp Dolor. 2002; 9:317-27.
5. Lago P, Garetti E, Boccuzzo G, Merazzi D, Pirelli A, Pieragostini L, et al. Procedural pain in neonates: the state of the art in the implementation of national guidelines in Italy. Pediatr Anesth. 2013; 23(5):407-14.
6. Guedj R, Danan C, Daoud P, Zupan V, Renolleau S, Zana E, et al. Does neonatal pain management in intensive care units differ between night and day? An observational study. BMJ open. 2014;4(2):e004086.
7. Ranger M, Grunau RE. Early repetitive pain in preterm infants in relation to the developing brain. Pain Manag. 2014;4(1): 57-67.
8. Grunau RE. Neonatal pain in very preterm infants: long-term effects on brain, neurodevelopment and pain Reactivity. Rambam Maimonides Med J. 2013 Oct 29;4(4):e0025.
9. Rodrigues AC, Guinsburg R. Pain evaluation after a non-nociceptive stimulus in preterm infants during the first 28days of life. Early Hum Dev. 2013;89(2):75-9.
10. Walker SM. Biological and neurodevelopmental implications of neonatal pain. Clin Perinatol. 2013; 40(3):471-91.
11. Vinall J, Miller SP, Chau V, Brummelte S, Synnes AR, Grunau RE. Neonatal pain in relation to postnatal growth in infants born very preterm. Pain. 2012;153(7):1374-81.
12. Consideraciones generales sobre dolor. En: Sociedad Venezolana de Puericultura y Pediatría. Dolor en pediatría. Caracas: Médica Panamericana; 2010. p. 16.
13. Mayock DE, Gleason CA. Pain and sedation in the NICU. NeoReviews. 2013;14(1): e22-31.
14. Holsti L, Grunau RE, Oberlander TF, Osiovich H. Is it painful or not? Discriminant validity of the Behavioral Indicators of Infant Pain (BIIP) scale. Clin J Pain. 2008 Jan;24(1):83-8.
15. Narbona López E, Contreras Chova F, García Iglesias F, Miras Baldo MJ. Manejo del dolor en el recién nacido. En: Asociación Española de Pediatría. Protocolos diagnósticos terapeúticos de la AEP: neonatología [monografía en Internet]. Madrid, España: AEP; 2008. [citado 15 Jul 2015]. Disponible en: http://www.aeped.es/sites/default/files/documentos/49.pdf. 36. Taddio A, Ohlsson A, Einarson TR, Stevens B, Koren G. A systematic review of lidocaine-prilocaine cream (EMLA) in the treatment of acute pain in neonates. Pediatrics. 1998;101(2):E1. 37.
16. Taylor BJ, Robbins JM, Gold JI, Logsdon TR, Bird T, Anand K. Assessing postoperative pain in neonates: a multicenter observational study. Pediatrics. 2006;118(4):e992-e1000.
17. Codipietro L, Bailo E, Nangeroni M, Ponzone A, Grazia G. Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy. Pain Prac. 2011;11(2):154-9.
18. an Dijk M, Peters JW, van Deventer P, Tibboel D. The COMFORT Behavior Scale: a tool for assessing pain and sedation in infants. Am J Nurs. 2005 Jan; 105(1):33-6.
19. Ozawa M, Yokoo K. Pain management of neonatal intensive care units in Japan. Acta Paediatr. 2013;102(4):366-72.
20. Shah V, Ohlsson A. Venepuncture versus heel lance for blood sampling in term neonates. The Cochrane database of systematic reviews. 2001(2):CD001452.
21. Franck LS, Oulton K, Nderitu S, Lim M, Fang S, Kaiser A. Parent involvement in pain management for NICU infants: a randomized controlled trial. Pediatrics. 2011 Sep; 128(3):510-8.
22. Allegaert K, Tibboel D. Shouldn’t we reconsider procedural techniques to prevent neonatal pain?. Eur J Pain. 2007;11(8):910-2.
23. American Academic of Pediatrics. Committee on Fetus Newborn. Section on Surgery, Canadian Paediatric Society. Fetus Newborn Committee. Prevention and management of pain in the neonate: an update. Pediatrics. 2006. 118(5): 2231-41.
24. Kumar P, Denson SE, Mancuso TJ. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010 Mar;125(3):608-15.
25. Harrison D, Beggs S, Stevens B. Sucrose for procedural pain management in infants. Pediatrics. 2012;130(5): 918-25.
26. Batton DG, Barrington KJ, Wallman C. Prevention and management of pain in the neonate: an update. Pediatrics. 2006 Nov; 118(5): 2231-41.
27. Campbell-Yeo M, Johnston C, Benoit B, Latimer M, Vincer M, Walker D, Streiner D, Inglis D, Caddell K. Trial of repeated analgesia with Kangaroo Mother Care. BMC pediatrics. 2013;13(1):182.
28. Scottish Intercollegiate Guidelines Network. SIGN 50: a guideline developer’s handbook [monograph on the Internet]. Edinburgh: SIGN; 2014. [cited 2014 Nov 14]. Available in: http://www.sign.ac.uk/pdf/sign50.pdf
29. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #23: Non-pharmacologic management of procedure-related pain in the breastfeeding infant. Breastfeed Med. 2010 Dec; 5(6):315-9.
30. Shah V, Ohlsson A. Venepuncture versus heel lance for blood sampling in term neonates. Cochrane Database Syst Rev. 2007 Oct 17; (4):CD001452.
31. Barker D, Willetts B, Cappendijk V, Rutter N. Capillary blood sampling: should the heel be warmed?. Arch Dis Child Fetal Neonatal Ed.1996;74(2):F139-40.
32. Johnston C, Campbell-Yeo M, Rich B, Whitley J, Filion F, Cogan J, et al. Therapeutic touch is not therapeutic for procedural pain in very preterm neonates: a randomized trial. Clin J Pain. 2013; 29(9):824-9.
33. Johnston C, Campbell-Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skinto-skin care for procedural pain in neonates. Cochrane Database Syst Rev. 2014; (1): CD008435.
34. O’Brien L, Taddio A, Lyszkiewicz DA, Koren G. A critical review of the topical local anesthetic amethocaine (Ametop) for pediatric pain. Pediatr Drugs. 2005;7(1):41-54.
35. Bonetto G, Salvatico E, Várela N, Cometto C, Gómez PF, Calvo B. Prevención del dolor en recién nacidos de término: estudio aleatorizado sobre tres métodos. Rev Soc Bol Ped. 2010; 49(2):108-13.
36. Taddio A, Ohlsson A, Einarson TR, Stevens B, Koren G. A systematic review of lidocaine-prilocaine cream (EMLA) in the treatment of acute pain in neonates. Pediatrics. 1998;101(2):E1.
37. Kluger N, Raison Peyron N, Michot C, Guillot B, Bessis D. Acute bullous irritant contact dermatitis caused by EMLA® cream. Contact Dermatitis. 2011;65(3):181-2.
38. Spence K, Henderson Smart D, New K, Evans C, Whitelaw J, Woolnough R. Evidenced based clinical practice guideline for management of newborn pain. J Paediatr Child Health. 2010;46(4):184-92.
39. Taddio A, Soin HK, Schuh S, Koren G, Scolnik D. Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: a randomized controlled trial. CMAJ. 2005;172(13):1691-5.
40. Taddio A, Shah V, Stephens D, Parvez E, Hogan M-E, Kikuta A, Koren G, Katz J. Effect of liposomal lidocaine and sucrose alone and in combination for venipuncture pain in newborns. Pediatrics. 2011;127(4):e940-7.
41. Niño A, Cristo J. Abordaje del dolor en el recién nacido. Guía de práctica clínica [monografía en Internet]. Bogotá: Universidad Militar Nueva Granada; 2014. [citado 17 Jul 2015]. Disponible en: http://repository.unimilitar.edu.co/bitstream/10654/10763/3/Ni%C3%B1oAdaVirginia2013.pdf
42. Yamada J, Stinson J, Lamba J, Dickson A, McGrath PJ, Stevens B. A review of systematic reviews on pain interventions in hospitalized infants. Pain Res Manag. 2008 Sep-Oct;13(5):413-20.
43. Walker S. Neonatal Pain. Paediatr Anaesth. 2014 Jan; 24(1): 39-48.
44. Ng E, Taddio A, Ohlsson A. Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit. Cochrane Database Syst Rev. 2012 Jun 13; 6: CD002052.
45. Harrison D, Beggs S, Stevens B. Sucrose for procedural pain management in infants. Pediatrics. 2012 Nov; 130(5): 918-25.
46. Wong C, Lau E, Palozzi L, Campbell F. Pain management in children: Part 1—Pain assessment tools and a brief review of nonpharmacological and pharmacological treatment options. Can Pharm J (Ott). 2012;145(5):222-5.
47. Anand K, McIntosh N, Lagercrantz H, Pelausa E, Young TE, Vasa R. Analgesia and sedation in preterm neonates who require ventilatory support: results from the NOPAIN trial. Arch Pediatr Adolesc Med. 1999;153(4):331-8.
48. Attarian S, Tran LC, Moore A, Stanton G, Meyer E, Moore RP. The neurodevelopmental impact of neonatal morphine administration. Brain Sci. 2014; 4(2): 321-34.
49. Storch De Gracia Calvo P, De La Torre Espí M, Martín Díaz M, García Ruiz S, Domínguez Ortega G, Novoa Carballal R, editors. ¿Se realiza correctamente la punción lumbar en pediatría?. Revisión de las recomendaciones actuales y análisis de la realidad. An Pediatr (Barc). 2012; 77(2): 115-23.
50. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009 Jun; 98(6): 932-9.