TUESDAY, July 1 (HealthDay News) -- Although tiny babies
receiving intensive care must undergo numerous painful
interventions, not enough is being done to reduce their discomfort,
new research suggests.
Of the 42,413 painful procedures included in this study, only 2
percent of babies received pain medications, and just 18.2 percent
received non-pharmacological pain therapy. That means about four
out of five babies received no interventions to lessen their pain,
according to the study, which was published in the July 2 issue of
the
Journal of the American Medical Association.
"We found that babies are exposed to a lot of painful and
stressful procedures, mostly not treated with pain-relieving
interventions," said study author Dr. Ricardo Carbajal, a professor
of pediatrics and chief of the National Center of Resources to
Fight Pain at Children's Hospital Armand Trousseau in Paris.
The authors explain that it's especially important to control
pain in neonates -- babies from 1 to 4 weeks old -- because they're
more sensitive to pain, and repeated or prolonged exposure may
alter the way their brains process pain. It may also affect their
long-term development and behavior, Carbajal added.
With funding from two nonprofit foundations -- Fondation CNP and
Fondation de France -- Carbajal and his colleagues reviewed data
from 430 neonates admitted to hospitals in the Paris area between
September 2005 and January 2006.
The average gestational age of the babies was 33 weeks -- a
full-term pregnancy is 40 weeks, so these infants were born almost
two months early. The average intensive care unit stay was just
over eight days, according to the study.
During that time, the 430 infants underwent more than 60,000
first-attempt procedures. Of these, 42,413 were painful, and 18,556
were stressful. The babies also underwent more than 11,000
supplemental attempt procedures, including 10,366 painful and 1,180
stressful procedures.
The average number of procedures was 141 per baby. The type of
procedure varied from a heel stick to draw blood to having to
insert a chest tube.
Carbajal said there are numerous factors why neonates aren't
receiving enough pain relief. One is a concern about side effects
from pharmacological interventions; another is unfamiliarity with
pain relief management for newborns and a lack of standardized
policies in this setting. He also said that pharmaceutical
companies haven't developed analgesic products especially for
neonates.
He recommended that procedures be done in combination whenever
possible, and that minor procedures should be accompanied by
non-pharmacological pain-reducing methods, such as providing oral
sucrose or glucose and sucking. He said topical anesthetics can be
used to reduce pain from needle punctures, though it's not
sufficient for heel stick pain. For major procedures, he said,
analgesia in combination in non-pharmacological therapy is
needed.
Carbajal said this study's findings would likely be similar in
other areas of the world where neonatal intensive care is
available.
"For most neonates who undergo any sort of painful procedure, it
would be worthwhile to have a combination of pharmacological and
non-pharmacological interventions," said Dr. Santhanam Suresh, an
anesthesiologist at Children's Memorial Hospital in Chicago.
Carbajal added that parents can act as advocates for optimal
pain management for their babies by asking the health-care team to
use approaches that "limit the intensity, frequency or duration of
pain."
More information
To learn more about pain and pain relief for babies, read this
information from the
University of Michigan.
