By Martin T. Stein, MD
The American Academy of Pediatrics has updated its recommendations for the prevention and management of procedural pain in neonates. Highlights of the policy statement, published in Pediatrics, include:
- Nonpharmacological strategies, such as swaddling, nonnutritive sucking, breast-feeding, and skin-to-skin care, are recommended for short-term mild to moderately painful procedures (e.g., heel lance and IV catheter insertion).
- Oral sucrose or glucose are safe and effective for mild to moderately painful procedures (e.g., immunizations) either alone or with nonnutritive sucking and swaddling.
- Pharmacologic treatments (e.g., opioids and benzodiazepines) may be used for more painful procedures, after balancing benefits and side effects. Topical anesthetics (tetracaine gel and EMLA) decrease pain during venipuncture and insertion of venous and arterial lines.
- Pain management is recommended for circumcision and nonemergency intubation.
Pediatrics policy statement (Free)
Full NEJM Journal Watch Pediatrics and Adolescent Medicine coverage (Free)
Background: NEJM Journal Watch Pediatrics and Adolescent Medicine summary on pain control in newborns (Free)