Consensus statement for the prevention and management of pain in the newborn

Objective: To develop evidence-based guidelines for preventing or treating neonatal pain and its adverse consequences. Compared with older children an d adults, neonates are more sensitive to pain and vulnerable to its longter m effects. Despite the clinical importance of neonatal pain, current medica l practices continue to expose infants to repetitive, acute, or prolonged p ain. Design: Experts representing several different countries, professional disc iplines, and practice settings used systematic reviews, data synthesis, and open discussion to develop a consensus on clinical practices that were sup ported by published evidence or were commonly used, the latter based on ext rapolation of evidence from older age groups. A practical format was used t o describe the analgesic management for specific invasive procedures and fo r ongoing pain in neonates. Results: Recognition of the sources of pain and routine assessments of neon atal pain should dictate the avoidance of recurrent painful stimuli and the use of specific environmental, behavioral, and pharmacological interventio ns. Individualized care plans and analgesic protocols for specific clinical situations, patients, and health care settings can be developed from these guidelines. By clearly outlining areas where evidence is not available, th ese guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with their adverse effe cts and the potential for drug interactions. Conclusion: Management of pain must be considered an import-ant component o f the health care provided to all neonates, regardless of their gestational age or severity of illness.