TY - JOUR
T1 - Practical approaches to sedation and analgesia in the newborn
AU - McPherson, Christopher
AU - Ortinau, Cynthia M.
AU - Vesoulis, Zachary
N1 - Funding Information:
Funding National Institutes of Health/National Institute of Neurological Disorders and Stroke K23 NS111086 (awarded to ZV) and National Institutes of Health/National Heart, Lung, and Blood Institute K23 HL141602 (awarded to CMO).
Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2021/3
Y1 - 2021/3
N2 - The prevention, assessment, and treatment of neonatal pain and agitation continues to challenge clinicians and researchers. Substantial progress has been made in the past three decades, but numerous outstanding questions remain. In this setting, clinicians must establish safe and compassionate standardized practices that consider available efficacy data, long-term outcomes, and research gaps. Novel approaches with limited data must be carefully considered against historic standards of care with robust data suggesting limited benefit and clear adverse effects. This review summarizes available evidence while suggesting practical clinical approaches to pain assessment and avoidance, procedural analgesia, postoperative analgesia, sedation during mechanical ventilation and therapeutic hypothermia, and the issues of tolerance and withdrawal. Further research in all areas represents an urgent priority for optimal neonatal care. In the meantime, synthesis of available data offers clinicians challenging choices as they balance benefit and risk in vulnerable critically ill neonates.
AB - The prevention, assessment, and treatment of neonatal pain and agitation continues to challenge clinicians and researchers. Substantial progress has been made in the past three decades, but numerous outstanding questions remain. In this setting, clinicians must establish safe and compassionate standardized practices that consider available efficacy data, long-term outcomes, and research gaps. Novel approaches with limited data must be carefully considered against historic standards of care with robust data suggesting limited benefit and clear adverse effects. This review summarizes available evidence while suggesting practical clinical approaches to pain assessment and avoidance, procedural analgesia, postoperative analgesia, sedation during mechanical ventilation and therapeutic hypothermia, and the issues of tolerance and withdrawal. Further research in all areas represents an urgent priority for optimal neonatal care. In the meantime, synthesis of available data offers clinicians challenging choices as they balance benefit and risk in vulnerable critically ill neonates.
UR - http://www.scopus.com/inward/record.url?scp=85096824307&partnerID=8YFLogxK
U2 - 10.1038/s41372-020-00878-7
DO - 10.1038/s41372-020-00878-7
M3 - Review article
C2 - 33250515
AN - SCOPUS:85096824307
SN - 0743-8346
VL - 41
SP - 383
EP - 395
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 3
ER -