Did you know reducing pain in the NICU remains a top priority in neonatal care?
Pain is a sensory and emotional experience, and research has shown that even the tiniest neonates experience pain. It has been proven the that perception of pain is well developed by 20-24 weeks gestation. Pain causes sympathetic stimulation, cortisol, aldosterone and epinephrine release, increased heart rate, increased blood pressure and vasoconstriction.
The severity of pain in the neonate has been underestimated due to nonverbal communication of pain, and therefore undertreated. Pain can be misunderstood as pain transmission travels slowly across unmyelinated nerves revealing its symptoms at varying times. Procedural pain is common, but also noise, light, and repeated medical touch adds to the pain experienced by the neonate in the NICU.
The assessment and treatment of neonatal pain is a common conversation amongst neonatal professionals especially considering the side-effects of many of the medications. Opioids and NSAIDs have many side effects including respiratory depression, pulmonary hypertension and NEC, and the topical agent EMLA cream is not recommended for use in neonates as it can lead to meth-hemoglobinemia.
Swaddling, sucrose, non-nutritive sucking, skin-to-skin holding, massage and gentle human touch provide nonpharmacologic pain management without side-effects. Authors recommend reducing exposure to painful procedures, providing pharmacologic treatment when needed, and utilizing non-pharmacologic methods to prevent and relieve pain in order to prevent the short and long-term effects of pain on the infant.
Pain in the NICU is not new. In fact, for decades researchers have been studying neonatal pain and working to understand how it’s experienced, processed and most importantly, reduced or eliminated. Non-pharmacological pain measures like swaddling, skin-to-skin holding and massage remain a top priority in daily neonatal care. During the Neonatal Touch & Massage Certification these are just a few of the many neuroprotective & neuropromotional skills you will learn! Apply & Register today to begin your journey to reduce pain and improve the outcomes of babies in your hospital today!