Acute perioperative pain in neonates: An evidence-based review of neurophysiology and management

Acta Anaesthesiol Taiwan. 2014 Mar;52(1):30-7. doi: 10.1016/j.aat.2014.02.004. Epub 2014 Apr 2.

Abstract

Current literature lacks systematic data on acute perioperative pain management in neonates and mainly focuses only on procedural pain management. In the current review, the neurophysiological basis of neonatal pain perception and the role of different analgesic drugs and techniques in perioperative pain management in neonates are systematically reviewed. Intravenous opioids such as morphine or fentanyl as either intermittent bolus or continuous infusion remain the most common modality for the treatment of perioperative pain. Paracetamol has a promising role in decreasing opioid requirement. However, routine use of ketorolac or other nonsteroidal anti-inflammatory drugs is not usually recommended. Epidural analgesia is safe in experienced hands and provides several benefits over systemic opioids such as early extubation and early return of bowel function.

Keywords: analgesia, epidural; analgesics, opioid; infant, newborn; pain, postoperative.

Publication types

  • Review

MeSH terms

  • Acetaminophen / administration & dosage
  • Acute Disease
  • Analgesia / methods
  • Analgesics, Opioid / administration & dosage
  • Anesthesia, Epidural / adverse effects
  • Evidence-Based Medicine
  • Humans
  • Infant, Newborn
  • Interpleural Analgesia
  • Pain / physiopathology*
  • Pain Management / methods*
  • Perioperative Period
  • Postoperative Care

Substances

  • Analgesics, Opioid
  • Acetaminophen