Frequency of painful procedures, analgesia practices and related factors in neonates across neonatal intensive care units of Portugal

Cruz, Maria Dulce

Fernandes, Ananda

Oliveira, Catarina

Repositório Científico da Universidade de Évora

XLIV  JORNADAS  NACIONAIS  DE  NEONATOLOGIA ÉVORA  HOTEL  –  5  E  6  DE  NOVEMBRO  DE  2015  57  CO75 - Epidemiology of procedural pain in neonatal intensive care units of Portugal Cruz MD1, Fernandes AM2, Oliveira CR3 1 UICISA-E, Évora University, Portugal, RN, MSoc, dcruz@uevora.pt 2 UICISA-E, Nursing School of Coimbra, Portugal, RN, PhD 3 Faculty of Medicine, University of Coimbra, Portugal, MD, PhD  Aims: To assess the frequency of painful procedures (PP), analgesia practices and related factors, in neonates across neonatal intensive care units (NICUs) of Portugal.  Methodology: EPIDOR-NN (Epidemiology of Neonatal Pain) was an observational cohort study in neonates recorded at the bedside by the NICUs staff. Prospective data were collected during six weeks in each unit, on all PP and pain management interventions performed during the first 7 days of the neonate admission. Neonates up to 28 days and admitted for a period over 24 hours were enrolled. Multinomial regression model were used to assess the association between demographics, type of painful procedures and analgesia. Ethical approval from institutions was obtained. Results: From April 1, 2013, to October 30, 2014, 19 of 20 NICUs collected data on 375 eligible neonates. The total number of PP was 6705 indicating a mean of 17.9 procedures performed per neonate. In all, 89.4% of the PP received either non-pharmacological and/or pharmacological interventions. Heel stick was the most common PP (32.3%). Preterm neonates (mean GA=33.3, SD 4.6; range 23-41) received more PP; p<0.001. Overall, procedures with moderate severity of pain [60.6% (n=4064)] received orally administered sweet solution as pre-emptive analgesia. Only 85 (1.3%) of PP had a severe pain intensity, and as expected received more pharmacological interventions; p<0.001. Conclusions: This was the first national multicentre study with focus on epidemiology of pain in neonates. Further discussion of overall pain management interventions is warranted. This is the first step to improve strategies to increase the quality of care.  Key words: Procedural pain, Pain management, Neonate. Acknowledgment: We thank the physicians and nurses at the participating institutions for their contributions and data collection. This study was encouraged by Portuguese Society of Neonatology and Pain in Child Health: a Canadian Institute of Health Research - Strategic Training Initiative in Health Research; Mayday Foundation; Grant of APED /Grünenthal Foundation.    

Epidemiology of procedural pain in neonatal intensive care units of Portugal

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Repositório Científico da Universidade de Évora