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Adequate Pain Management and Sedation in the Neonate: a Fine Balance

  • Neonatology (T Thorkelsson, Section Editor)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of review

With heightened awareness of long-term neurocognitive effects of pain and stress in the neonatal population, increased focus has been placed on pain assessment as well as potential effects of routinely administered analgesics/sedatives in our neonatal intensive care units (NICUs). Our goal was to review recently published literature on current pain assessment practices, novel approaches to management, pharmacogenomics in the neonate, and risks of commonly used medications.

Recent findings

There is an increasing trend in the administration of analgesics and sedatives in NICUs, despite reports of the negative effects these medications may have on neonatal brain development. As in the adult world, studies are finding that pharmacogenomics has the potential to play a significant role in adequate pain control and sedation in the individual neonatal patient. Due to increased reports of adverse effects of commonly used medications such as morphine and midazolam, new pharmacologic agents are being evaluated in the neonatal population as possibly safer alternatives.

Summary

There have been significant advances in our knowledge of pain and sedation in the neonate, ranging from a better understanding of long-term neurocognitive effects of pain in neonatal brain development to the role of pharmacogenomics in the NICU setting. These developments have opened the door for continued learning and investigation into the ideal management of neonatal pain and sedation.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Author information

Authors and Affiliations

  1. Division of Neonatology, Children’s Mercy Hospital Kansas City, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lauren Cummings DO

  2. Divisions of Neonatology and Pediatric Clinical Pharmacology, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Tamorah Lewis MD, PhD

  3. Divisions of Neonatology and Bioethics, Children’s Mercy Hospital Kansas City, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Brian S. Carter MD

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  1. Lauren Cummings DO
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Corresponding author

Correspondence to Brian S. Carter MD.

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Conflict of Interest

Lauren Cummings declares that she has no conflict of interest. Tamorah Lewis declares that she has no conflict of interest. Brian S. Carter declares that he has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Neonatology

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Cummings, L., Lewis, T. & Carter, B.S. Adequate Pain Management and Sedation in the Neonate: a Fine Balance. Curr Treat Options Peds 4, 108–118 (2018). https://doi.org/10.1007/s40746-018-0109-0

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  • DOI: https://doi.org/10.1007/s40746-018-0109-0

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