Assessment of Continuous Pain in Newborns admitted to NICUs in 18 European Countries

Anand, Kanwaljeet; Eriksson, Mats; Boyle, Elaine; Avila-Alvarez, Alejandro; Andersen, Randi Dovland; Sarafidis, Kosmas; Polkki, Tarja; Matos, Cristina; Lago, Paola; Papadouri, Thalia; Attard-Montaldo, Simon; Ilmoja, Mari-Liis; Simons, Sinno; Tameliene, Rama; van Overmeire, Bart; Berger, Angelika; Dobrzanska, Anna; Schroth, Michael; Berqvist, Lena; Courtois, Emilie; Rousseau, Jessica; Carbajal, Ricardo

doi:10.1111/apa.13810

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Assessment of Continuous Pain in Newborns admitted to NICUs in 18 European Countries

Anand, Kanwaljeet; Eriksson, Mats; Boyle, Elaine et al.

2017 • In Acta Paediatrica, 106 (8), p. 1248-59

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/210470

DOI
10.1111/apa.13810

PubMed
28257153

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Keywords :

pain; newborn, infant; neonatal intensive care; pain assessment

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.

Disciplines :

Pediatrics

Author, co-author :

Anand, Kanwaljeet; Standford University school of medicine, USA

Eriksson, Mats; Orebro University, Sweden

Boyle, Elaine; University of Leicester, UK

Avila-Alvarez, Alejandro; Complexo Hospitalario Universitario de A Coruña, Espagne

Andersen, Randi Dovland; Telemark Hospital, Norway

Sarafidis, Kosmas; Aristotle University of Thessaloniki, Grèce

Polkki, Tarja; Oulu University Hospital, Finlande

Matos, Cristina; Maternidade Dr. Alfredo da Costa, Portugal

Lago, Paola; University of Padua, Italie

Papadouri, Thalia; Arch. Makarios III Hospital, Nicosie, Chypre

More authors (12 more)

Other collaborator :

the EUROPAIN survey working group of the NeoOpioid Consortium.

RIGO, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > Service néonatologie (CHR)

Language :

English

Title :

Assessment of Continuous Pain in Newborns admitted to NICUs in 18 European Countries

Publication date :

August 2017

Journal title :

Acta Paediatrica

ISSN :

0803-5253

eISSN :

1651-2227

Publisher :

Taylor & Francis, Oslo, Norway

Volume :

106

Issue :

Pages :

1248-59

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

http://onlinelibrary.wiley.com/doi/10.1111/apa.13810/full

Available on ORBi :

since 12 May 2017

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