Managing Pain Flashcards
What are some of the complications associated or postulated to be associated with neonatal pain?
Altered pain sensitivity - which may last into adolescence
Permanent neuroanatomical and behavioural abnormalities
Why should be we treat neonatal pain
Ethical responsibility
Long term complications
What are some methods to treat pain in neonates?
Oral sucrose
Non pharmacological: non-nutritive sucking, kangaroo care, facilicated tuck, swaddling and developmental care
Pharmacological therapy
When should you use topical anaesthetic?
When is topical anaesthetic not effective?
Venipuncture
lumbar puncture
IV catheter insertion
NOT: heal pricks
Should we be using infusions of analgesias for ventilated babies?
No, because of concern about short term side effects and lack of long term outcome data
What measures should be taken to reduce pain from surgery?
- have a pain protocol - coordinated MDT strategy preoperatively
- good anaesthetic intraoperative - decreased stress response and post-operative pain requirements
- Assess pain routinely
Use regional anaesthesia when possible
-Opioids should be the basis of the analgesia
+/- tylenol
Can you give tylenol to preterm infants?
It can be used after sugar as an adjunct. There is limited information on the pharmacokinetic at GA
What class of drugs should be the basis of analgesia management in neonates?
Opioids
What can you do to minimise the pain of CT insertion?
General non-pharmacological measures
Slow infiltration with local anaesthesia, unless life threatening
Systemic analgesia that is rapid acting (fentanyl)
Do you need to use analgesia for removing CTs?
yes: pharmacological measures and something rapid onset like fentanyl
Do you need to use analgesia for ROP examinations?
Yes - ROP exams are painful, however the insufficient data to suggest exactly which analgesia should be used. Currently using local anaesthetic eye drops and oral sucrose
Should there be analgesia for circumcision?
Yes.
