Current practices in neonatal pain management: a decade after the last Italian survey
Abstract Background Neonates admitted to neonatal intensive care units (NICUs), as well as maternity nurseries, typically undergo painful invasive procedures during their hospital stay. We aim to report on current bedside analgesia/sedation and pain assessment practices, 10 years after the previous...
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2025-02-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-025-01896-x |
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| author | Paola Lago Elisabetta Garetti Patrizia Savant Levet Immacolata Arenga Anna Pirelli Anna Chiara Frigo Daniele Merazzi on behalf Pain Study Group of Italian Society of Neonatology |
| author_facet | Paola Lago Elisabetta Garetti Patrizia Savant Levet Immacolata Arenga Anna Pirelli Anna Chiara Frigo Daniele Merazzi on behalf Pain Study Group of Italian Society of Neonatology |
| author_sort | Paola Lago |
| collection | DOAJ |
| description | Abstract Background Neonates admitted to neonatal intensive care units (NICUs), as well as maternity nurseries, typically undergo painful invasive procedures during their hospital stay. We aim to report on current bedside analgesia/sedation and pain assessment practices, 10 years after the previous Italian survey. Methods This study employed a cross-sectional electronic survey. A 21-item questionnaire was distributed to directors of birth centers and NICUs to ascertain the policy for pain assessment and management in their respective units. A separate questionnaire was dispatched to neonatologists and nurses registered with the Italian Society of Neonatology. They reported on the analgesic strategies implemented for various painful bedside procedures. Both non-pharmacological and pharmacological analgesia interventions, as well as pain assessment, were analyzed. A regression model was utilized to identify factors that predict pain management practices. Results Data on pain management practices were collected from the directors of 153 NICUs and birth centers. Of these, 88.9% reported pain control following guidelines and 47.7% confirmed the presence of a local pain specialist promoting pain management in their unit. A minority, ranging from 16.3% to 41.8%, reported the use of a pain scale, a finding corroborated by the 200 doctors and 239 nurses who responded. At least one non pharmacological intervention (i.e., pacifier, sweet solution, or sensory saturation) was reported in 97.8% of the heel lances performed in the NICU and 96.5% in the maternity nursery, meanwhile for intramuscular injections in 73.8% and 70.3%, respectively. Additionally, it was reported that 22.9% of laryngoscopies were still performed without analgesia. Observations were made over 297 mechanical ventilation and 277 non-invasive ventilation courses, with non-pharmacological analgesia administered in 56.4% and 86.9% and the use of analgesic or sedative drugs in 81.7% and 17.1% of the cases, respectively. Furthermore, routine pain assessment was only undertaken in 68.0% and 64.9% of the cases. Conclusions We found a largely common propensity among Italian directors, neonatologists, and nurses to perform analgesic interventions for the most frequently encountered invasive neonatal painful procedures, though the practices are still highly variable. The availability of written guidelines and local pain specialists are confirmed as factors that contribute to the proper management of pain. However, pain assessment is still inadequate and urgently needs to be implemented to allow for tailored pain and stress control and prevention in all infants. |
| format | Article |
| id | doaj-art-2e8db5ff32a54097b9b22f11373206e6 |
| institution | DOAJ |
| issn | 1824-7288 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj-art-2e8db5ff32a54097b9b22f11373206e62025-08-20T02:43:16ZengBMCItalian Journal of Pediatrics1824-72882025-02-0151111010.1186/s13052-025-01896-xCurrent practices in neonatal pain management: a decade after the last Italian surveyPaola Lago0Elisabetta Garetti1Patrizia Savant Levet2Immacolata Arenga3Anna Pirelli4Anna Chiara Frigo5Daniele Merazzi6on behalf Pain Study Group of Italian Society of NeonatologyNeonatal Intensive Care Unit, Critical Care Department, Ca’ Foncello Regional HospitalNeonatal Intensive Care Unit, Women’s and Children’s Health Department, Azienda Ospedaliera-University of ModenaNeonatal Intensive Care Unit, Maria Vittoria HospitalNeonatal Intensive Care Unit University P.O. Sant’Anna A.O.U.Pediatric - NeonatologistDepartment of Cardiac, Thoracic and Vascular Sciences, University of PaduaMother’s and Infant’s Department, Valduce HospitalAbstract Background Neonates admitted to neonatal intensive care units (NICUs), as well as maternity nurseries, typically undergo painful invasive procedures during their hospital stay. We aim to report on current bedside analgesia/sedation and pain assessment practices, 10 years after the previous Italian survey. Methods This study employed a cross-sectional electronic survey. A 21-item questionnaire was distributed to directors of birth centers and NICUs to ascertain the policy for pain assessment and management in their respective units. A separate questionnaire was dispatched to neonatologists and nurses registered with the Italian Society of Neonatology. They reported on the analgesic strategies implemented for various painful bedside procedures. Both non-pharmacological and pharmacological analgesia interventions, as well as pain assessment, were analyzed. A regression model was utilized to identify factors that predict pain management practices. Results Data on pain management practices were collected from the directors of 153 NICUs and birth centers. Of these, 88.9% reported pain control following guidelines and 47.7% confirmed the presence of a local pain specialist promoting pain management in their unit. A minority, ranging from 16.3% to 41.8%, reported the use of a pain scale, a finding corroborated by the 200 doctors and 239 nurses who responded. At least one non pharmacological intervention (i.e., pacifier, sweet solution, or sensory saturation) was reported in 97.8% of the heel lances performed in the NICU and 96.5% in the maternity nursery, meanwhile for intramuscular injections in 73.8% and 70.3%, respectively. Additionally, it was reported that 22.9% of laryngoscopies were still performed without analgesia. Observations were made over 297 mechanical ventilation and 277 non-invasive ventilation courses, with non-pharmacological analgesia administered in 56.4% and 86.9% and the use of analgesic or sedative drugs in 81.7% and 17.1% of the cases, respectively. Furthermore, routine pain assessment was only undertaken in 68.0% and 64.9% of the cases. Conclusions We found a largely common propensity among Italian directors, neonatologists, and nurses to perform analgesic interventions for the most frequently encountered invasive neonatal painful procedures, though the practices are still highly variable. The availability of written guidelines and local pain specialists are confirmed as factors that contribute to the proper management of pain. However, pain assessment is still inadequate and urgently needs to be implemented to allow for tailored pain and stress control and prevention in all infants.https://doi.org/10.1186/s13052-025-01896-xPainNewborn and pretermAnalgesicSedativeOpioidsNon-pharmacological and pharmacological interventions |
| spellingShingle | Paola Lago Elisabetta Garetti Patrizia Savant Levet Immacolata Arenga Anna Pirelli Anna Chiara Frigo Daniele Merazzi on behalf Pain Study Group of Italian Society of Neonatology Current practices in neonatal pain management: a decade after the last Italian survey Italian Journal of Pediatrics Pain Newborn and preterm Analgesic Sedative Opioids Non-pharmacological and pharmacological interventions |
| title | Current practices in neonatal pain management: a decade after the last Italian survey |
| title_full | Current practices in neonatal pain management: a decade after the last Italian survey |
| title_fullStr | Current practices in neonatal pain management: a decade after the last Italian survey |
| title_full_unstemmed | Current practices in neonatal pain management: a decade after the last Italian survey |
| title_short | Current practices in neonatal pain management: a decade after the last Italian survey |
| title_sort | current practices in neonatal pain management a decade after the last italian survey |
| topic | Pain Newborn and preterm Analgesic Sedative Opioids Non-pharmacological and pharmacological interventions |
| url | https://doi.org/10.1186/s13052-025-01896-x |
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