Abstract
Introduction: There are still few data on the impact of pharmacologic treatment of pain during neonatal stay in preterm infants on pain expression after neonatal stay. We therefore investigated pain expression in former preterm infants at first immunisation with Palivisumab (Synagis®) in a cohort of former preterm infants who were treated with NICU-specific analgesia protocol, based on systematic evaluation of pain and an algorithm based use of intravenous analgesics.
Methods: Videotapes were made in former premature infants at first intramuscular administration of Palivizumab. Crying time (seconds) was registered based on these video recordings. Characteristics at time of immunisation and data on neonatal stay (surgery, ventilation, fentanyl administration) were retrospectively collected. Mann-Whitney U test, t test or Spearman rank correlation were used to study potential effects of neonatal variables on crying time.
Results: Videotapes at immunisation were collected in 42 infants of a median gestational age (GA) of 28 (range 25–32) weeks. Median duration of ventilation was 10 (range 0–46) days and median duration of fentanyl administration was 22 (0–672) hours. Thirteen infants received at least one surgical intervention during their neonatal stay. Median postconceptional age at immunisation was 60 (34–90) weeks. Median crying time at immunisation was 44 (range 0–112) seconds. There was no significant correlation of either GA or duration of ventilation or duration of fentanyl administration on crying time. There was no significant difference in crying time between infants who underwent surgery or not.
Conclusions: In a cohort of preterm infants in whom systematic evaluation of pain and an algorithm based administration of analgesics was part of their routine neonatal care, no significant differences in pain expression were observed at immunisation in their first year of life. These findings are suggestive for appropriate analgesia during intensive care, i.e. to treat pain when documented by pain score, while at the same time, such an approach can avoid systematic administration of analgesics.
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Allegaert, K., Debeer, A., Naulaers, G. et al. 6 Impact of Administration of Analgesics During Neonatal Stay on Pain Expression Following Neonatal Stay in Former Preterm Infants. Pediatr Res 56, 465 (2004). https://doi.org/10.1203/00006450-200409000-00029
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DOI: https://doi.org/10.1203/00006450-200409000-00029