• Paola Lago, Annamaria Guadagni, Daniele Merazzi, Gina Ancora, Carlo Valerio Bellieni, Alessandra Cavazza, and Pain Study Group of the Italian Society of Neonatology.
• Neonatal Intensive Care Unit, Department of Pediatrics, University of Padova, Padova, Italy. lago@pediatria.unipd.it
• Paediatr Anaesth. 2005 Nov 1;15(11):925-31.

BackgroundThis study assessed current medical practice in preventative analgesia and sedation for invasive procedures in neonatal intensive care units (NICU) in Italy.MethodsA questionnaire was sent to level II and III Italian NICUs to investigate pain management, pharmacological treatment and the use of pain scores during invasive procedures. Main outcome measures were the extent to which analgesia and sedation are currently used for invasive procedures in Italian neonatal units.ResultsThe rate of response to the questionnaire was 88%. Written guidelines were available on acute pain control in 25% of the NICUs, and on prolonged pain control in 50%. Routine use of preventative pharmacological and nonpharmacological measures for painful procedures ranged from 13% for elective tracheal intubation to 68% for chest tube insertion. Thirty-six percent of NICUs routinely use sedation with opioids for mechanical ventilation; 14% prevent distress and pain for tracheal suctioning, 44% for heel lancing, 50% for venepuncture and percutaneous venous catheter insertion; 58% use analgesia before lumbar puncture. Validated pain assessment scores were used by 19% of NICUs.ConclusionsThe need for adequate analgesia is still underestimated. Further information on the safety of analgesics in neonatology is imperative, as is an adequate education of physicians and nurses on the use of pain control guidelines as part of the standard of care in the NICU.

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