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Neonatal Pain pp 103-108 | Cite as

Pharmacologic Analgesia in the Newborn

  • A. M. Guadagni

Abstract

There is increasing evidence that neuroanatomic and neuroendocrine components for the perception and transmission of painful stimuli are fully developed in the newborn even when preterm. Incomplete myelination only means slower transmission. Pain in the newborn increases heart rate, mean airway pressure, O2 consumption, and levels of catecholamines, corticosteroids, and glucagons; decreases arterial O2 saturation; produces acidosis, hyperglycemia, and pulmonary hypertension; and increases susceptibility to infections and intraventricular hemorrhage (preterms) [1, 2]. Untreated pain may in fact exacerbate injury, increase the incidence of neurological handicap, lead to infection, prolong hospitalization, and may even lead to death [3, 4].

Keywords

Epidural Infusion Heel Prick Heel Lance Neuroendocrine Component Neonatal Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Anand KJ, Hickey PR (1987) Pain and its effects in the human neonate and fetus. N Engl JMed 317:1321–1329CrossRefGoogle Scholar
  2. 2.
    Barker DP, Rutter N (1995) Exposure to invasive procedures in neonatal intensive care admissions. Arch Dis Child 72:F47–F48Google Scholar
  3. 3.
    Anand KJS, Barton BA, McIntosh N et al (1999) Analgesia and sedation in preterm neonates who require ventilatory support. Results from the NOPAIN trial. Arch Pediatr Adolesc Med 153:331–338PubMedGoogle Scholar
  4. 4.
    Barker DP, Rutter N (1996) Stress, severity of illness, and outcome in ventilated preterm infants. Arch Dis Child Fetal Neonatal Ed 75:F187–F190PubMedGoogle Scholar
  5. 5.
    Dubner R, Gold M (1999) The neurobiology of pain. Proc Natl Acad Sci USA 96:7627–7630PubMedCrossRefGoogle Scholar
  6. 6.
    Anand KJS, International Evidence-Based Group for Neonatal Pain (2001) Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med 155:173–180PubMedGoogle Scholar
  7. 7.
    Blass EM (1991) Sucrose as an analgesic for newborn infants. Pediatrics 87:215PubMedGoogle Scholar
  8. 8.
    Bucher HW (1995) Sucrose reduce pain reaction to heel lancing in preterm infants. Pediatr Res 38:332–335PubMedGoogle Scholar
  9. 9.
    Stevens B (1997) The efficacy of sucrose for relieving procedural pain in neonates. Arch Pediatr 86:837–842Google Scholar
  10. 10.
    Bellieni CV, Bagnoli F, Perrone S et al (2002) Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial. Pediatr Res 51:460–463PubMedCrossRefGoogle Scholar
  11. 11.
    Gourrier E (1995) Use of EMLA cream in premature and full-term newborn infants. Study of efficacy and tolerance. Arch Pediatr 2:1041–1046PubMedCrossRefGoogle Scholar
  12. 12.
    Taddio A (1996) Safety of lidocaine-prilocaine cream in preterm and full term neonates. Pediatr Res 39:80ACrossRefGoogle Scholar
  13. 13.
    Autret E, Dutertre JP, Breteau M et al (1993) Pharmacokinetics of paracetamol in neonate and infant after administration of proparacetamol chlorhydrate. Dev Pharmacol Ther 20:129–134PubMedGoogle Scholar
  14. 14.
    Shah V, Taddio A, Ohlsson A (1998) Randomised controlled trial of paracetamol for heel prick pain in neonates. Arch Dis Child 79:F209–F211Google Scholar
  15. 15.
    Orsini AJ (1996) Routine use of fentanyl infusion for pain and stress reduction in infants with respiratory distress. J Pediatr 129:140–145PubMedCrossRefGoogle Scholar
  16. 16.
    Quinn MW, Wild J, Dean HG et al (1993) Randomised double-blind controlled trial of effect of morphine on catecholamine concentrations in ventilated preterm babies. Lancet 342:324–327PubMedCrossRefGoogle Scholar
  17. 17.
    Dyke MP, Kohan R, Evans S (1995) Morphine increases synchronous ventilation in preterm infants. J Paediatr Child Health 31:176–179PubMedGoogle Scholar
  18. 18.
    Pokela ML (1994) Pain relief can reduce hypoxemia in distressed neonates during routine treatment procedures. Pediatrics 93:379–383PubMedGoogle Scholar
  19. 19.
    Goldstein RF, Brazy JE (1991) Narcotic sedation stabilizes arterial blood pressure fluctuations in sick premature infants. J Perinatol 11:365–371PubMedGoogle Scholar
  20. 20.
    Saarenmaa E, Huttunen P, Leppäluoto J et al (1999) Advantages of fentanyl over morphine in analgesia for ventilated newborn infants after birth: a randomized trial. J Pediatr 134:144–150PubMedCrossRefGoogle Scholar
  21. 21.
    Davis PJ, Galinkin J, McGowan FX et al (2001) A randomised multicenter study of remifentaniyl compared with halothane in neonates and infants undergoing pyloromyotomy. Anesth Analg 93:1380–1386PubMedCrossRefGoogle Scholar
  22. 22.
    Chiaretti A, Pietrini D, Piastra M et al (2000) Safety and efficacy of remifentaniyl in craniosynostosis repair in children less than 1 year old. Pediatr Neurosurg 33:83–88PubMedCrossRefGoogle Scholar
  23. 23.
    Barrington KJ (1998) Premedication for neonatal intubations. Am J Perinatol 15:213–216PubMedCrossRefGoogle Scholar
  24. 24.
    Suresh S, Anand KJS (2001) Opioid tolerance in neonates: a state of the art review. Pediatr Anaesth 11:511–521CrossRefGoogle Scholar
  25. 25.
    Yeh GC, Tao PL, Chen JY et al (2002) Dextromethorphan attenuates morphine withdrawal syndrome in neonatal rats passively exposed to morphine. Eur J Pharmacol 453:197–202PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • A. M. Guadagni
    • 1
  1. 1.Department of Medical and Surgical NeonatologyBambin Gesù Pediatric Hospital - I.R.C.C.S. - RomaItaly

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