Adequate Pain Management and Sedation in the Neonate: a Fine Balance
Purpose of review
With heightened awareness of long-term neurocognitive effects of pain and stress in the neonatal population, increased focus has been placed on pain assessment as well as potential effects of routinely administered analgesics/sedatives in our neonatal intensive care units (NICUs). Our goal was to review recently published literature on current pain assessment practices, novel approaches to management, pharmacogenomics in the neonate, and risks of commonly used medications.
There is an increasing trend in the administration of analgesics and sedatives in NICUs, despite reports of the negative effects these medications may have on neonatal brain development. As in the adult world, studies are finding that pharmacogenomics has the potential to play a significant role in adequate pain control and sedation in the individual neonatal patient. Due to increased reports of adverse effects of commonly used medications such as morphine and midazolam, new pharmacologic agents are being evaluated in the neonatal population as possibly safer alternatives.
There have been significant advances in our knowledge of pain and sedation in the neonate, ranging from a better understanding of long-term neurocognitive effects of pain in neonatal brain development to the role of pharmacogenomics in the NICU setting. These developments have opened the door for continued learning and investigation into the ideal management of neonatal pain and sedation.
KeywordsNeonatal intensive care unit NICU Neonatal pain Neonatal sedation
Compliance with Ethical Standards
Conflict of Interest
Lauren Cummings declares that she has no conflict of interest. Tamorah Lewis declares that she has no conflict of interest. Brian S. Carter declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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