Acute Pain Management in Newborn Infants

Clinicians balance the immediate risks and benefi ts of analgesia in infancy, but they also consider the long-term effects of repetitive acute pain against those of prolonged analgesic therapy on brain development. This issue of Pain: Clinical Updates summarizes the current evidence regarding acute pain management in newborns. In 2006, the American Academy of Pediatrics and the Canadian Pediatric Society published new guidelines1 recommending that each health care facility that treats neonates establish a neonatal pain control program. The responsibilities of this program include: • Providing routine assessments to detect neonatal pain • Reducing the number of painful procedures • Preventing or treating acute pain from bedside invasive procedures • Anticipating and treating postoperative pain following surgery • Avoiding prolonged or repetitive pain and stress during neonatal intensive care Despite these recommendations, acute neonatal pain results from 8.5 million untreated painful procedures annually in neonatal intensive care units in Europe,2 which extrapolates to 120 million painful procedures performed annually in newborns worldwide. Effective pharmacological and nonpharmacological therapies are available for acute neonatal pain, which can be used alone or in combination to treat medically induced acute pain in newborns3 (see Fig. 1).