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    More Pain Relief Needed for Newborns, Studies Find

    By Jennifer Huddleston, staff writer     

    Two recent studies have exposed newborns’ need for pain relief during the first days of their lives.

    One study revealed that during the 42,413 painful procedures included in the analysis, just 2 percent of babies were given pain medications and 18.2 percent received non-pharmacological pain therapy—meaning that approximately four out of five babies did not receive treatment to help alleviate their pain.

    The study, led by 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, included data from 430 neonates (babies one to four weeks old) who were admitted to Paris-area hospitals between September 2005 and January 2006. The infants were born an average of two months early and remained in intensive care for an average of eight days, during which time each baby underwent an average of 141 procedures ranging from heel sticks to the insertion of chest tubes.

    The findings of the study were published July 2, 2008, in the Journal of the American Medical Association.

    Carbajal cited numerous reasons why neonates do not receive enough pain relief, including concerns about side effects, unfamiliarity with pain management for infants, a lack of standardized policies and the fact that pharmaceutical companies have yet to develop analgesics for newborns.

    Controlling pain in neonates is especially important because they are more sensitive to pain and prolonged or repeated pain could affect the development of their nervous systems and the way they process pain. For now, Carbajal recommends that minor procedures include non-pharmacological pain relief methods, including administering oral sucrose.

    Sucrose is believed to activate the body’s pain-relieving opioid system and is routinely administered into babies’ mouths before painful procedures instead of using medications with unknown or non-researched effects on infants.

    Another recent study, however, suggests that sucrose may not be as effective as originally believed. Findings of a new Canadian study, published July 1, 2008, in the Canadian Medical Association Journal, revealed that administering sucrose to newborns does not significantly reduce the pain they suffer while undergoing routine procedures shortly after birth.

    Researchers studied 240 newborns in which one group was given sucrose while the other group was given a placebo. The findings showed that sucrose did not work as well as expected during the first day of life and that while sucrose was highly effective during venipuncture, it was not as effective during other procedures such as heel sticks or vitamin K injections.

    Researchers used the Premature Infant Pain Profile, which measures the baby’s facial expressions, heart rate and oxygen saturation to measure overall pain levels, and found that the infants who received sucrose experienced a “modest reduction” in pain (about 16 percent) compared to those who received a placebo.

    While there is no harm in administering sucrose, more studies are needed to determine why it is not an effective analgesic for all procedures, said Dr. Anna Taddio, lead author of the study and associate professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy.

    [1] Newborns in Intensive Care Often Exposed to Pain. HealthDay. July 1, 2008.
    [2] Ibid.
    [3]  Ibid.
    [4]  Ibid.
    [5]  Ibid.
    [6] Weeks, Carly. Babies Need More than Sugar to Ease Their Pain, Study Finds. Globe and Mail Update. July 1, 2008.
    [7]  Ibid.
    [8]  Ibid.
    [9]  Ibid.
    [10]  Ibid.

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