Analgosedation in neonates: what we know and how we act
Karel Allegaert,1,2 Carlo V Bellieni3 1Department of Development and Regeneration, 2KU Leuven and Neonatal Intensive Care Unit, University Hospitals Leuven, Belgium; 3Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Siena, Italy Abstract: Inadequate pain managemen...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2013-11-01
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| Series: | Research and Reports in Neonatology |
| Online Access: | http://www.dovepress.com/analgosedation-in-neonates-what-we-know-and-how-we-act-a15048 |
| _version_ | 1811201753658425344 |
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| author | Allegaert K Bellieni CV |
| author_facet | Allegaert K Bellieni CV |
| author_sort | Allegaert K |
| collection | DOAJ |
| description | Karel Allegaert,1,2 Carlo V Bellieni3 1Department of Development and Regeneration, 2KU Leuven and Neonatal Intensive Care Unit, University Hospitals Leuven, Belgium; 3Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Siena, Italy Abstract: Inadequate pain management in neonatal life impairs the neurodevelopmental outcome. It alters pain thresholds, pain and stress-related behavior, and physiologic responses in later life. At the same time, there are emerging animal experimental and human epidemiologic data on the impact of analgosedatives on neuroapoptosis and impaired neurodevelopmental outcome. As a consequence, the management of neonatal pain is in search of a new equilibrium since these conflicting (undertreatment versus overtreatment) observations are the main drivers of its current management. Such tailoring includes new treatment modalities, and also more effective implementation strategies. The search for tailored nonpharmacologic (ie, less invasive techniques, preventive strategies, complementary techniques) and pharmacologic (eg, dexmedetomidine, intravenous acetaminophen, remifentanil) treatment modalities are discussed and reflect the increased knowledge on neonatal pain management. Despite this increasing knowledge (“toolbox”) regarding neonatal pain, there is still a major gap between knowledge (“what we know”) and practice (“how we act”). Consequently, more research activity on methods for effective implementation of the available knowledge is needed. Illustrations of effective approaches, eg, the Evidence-Based Practice for Improving Quality (EPIQ) initiative, to bridge this gap are provided. This is followed by an intersubjective proposal on priorities for contemporary clinical management and a research agenda. Keywords: pain, newborn, prevention, guidelines |
| first_indexed | 2024-04-12T02:27:11Z |
| format | Article |
| id | doaj.art-ddddaadd250b46b8bb1a66856ab4c2cd |
| institution | Directory Open Access Journal |
| issn | 1179-9935 |
| language | English |
| last_indexed | 2024-04-12T02:27:11Z |
| publishDate | 2013-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Research and Reports in Neonatology |
| spelling | doaj.art-ddddaadd250b46b8bb1a66856ab4c2cd2022-12-22T03:51:57ZengDove Medical PressResearch and Reports in Neonatology1179-99352013-11-012013default5161Analgosedation in neonates: what we know and how we actAllegaert KBellieni CVKarel Allegaert,1,2 Carlo V Bellieni3 1Department of Development and Regeneration, 2KU Leuven and Neonatal Intensive Care Unit, University Hospitals Leuven, Belgium; 3Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Siena, Italy Abstract: Inadequate pain management in neonatal life impairs the neurodevelopmental outcome. It alters pain thresholds, pain and stress-related behavior, and physiologic responses in later life. At the same time, there are emerging animal experimental and human epidemiologic data on the impact of analgosedatives on neuroapoptosis and impaired neurodevelopmental outcome. As a consequence, the management of neonatal pain is in search of a new equilibrium since these conflicting (undertreatment versus overtreatment) observations are the main drivers of its current management. Such tailoring includes new treatment modalities, and also more effective implementation strategies. The search for tailored nonpharmacologic (ie, less invasive techniques, preventive strategies, complementary techniques) and pharmacologic (eg, dexmedetomidine, intravenous acetaminophen, remifentanil) treatment modalities are discussed and reflect the increased knowledge on neonatal pain management. Despite this increasing knowledge (“toolbox”) regarding neonatal pain, there is still a major gap between knowledge (“what we know”) and practice (“how we act”). Consequently, more research activity on methods for effective implementation of the available knowledge is needed. Illustrations of effective approaches, eg, the Evidence-Based Practice for Improving Quality (EPIQ) initiative, to bridge this gap are provided. This is followed by an intersubjective proposal on priorities for contemporary clinical management and a research agenda. Keywords: pain, newborn, prevention, guidelineshttp://www.dovepress.com/analgosedation-in-neonates-what-we-know-and-how-we-act-a15048 |
| spellingShingle | Allegaert K Bellieni CV Analgosedation in neonates: what we know and how we act Research and Reports in Neonatology |
| title | Analgosedation in neonates: what we know and how we act |
| title_full | Analgosedation in neonates: what we know and how we act |
| title_fullStr | Analgosedation in neonates: what we know and how we act |
| title_full_unstemmed | Analgosedation in neonates: what we know and how we act |
| title_short | Analgosedation in neonates: what we know and how we act |
| title_sort | analgosedation in neonates what we know and how we act |
| url | http://www.dovepress.com/analgosedation-in-neonates-what-we-know-and-how-we-act-a15048 |
| work_keys_str_mv | AT allegaertk analgosedationinneonateswhatweknowandhowweact AT bellienicv analgosedationinneonateswhatweknowandhowweact |