A survey of the use of analgesia in newborn intensive care

Abstract

Abstract The use of analgesia and sedation in 70 United Kingdom units which practise newborn intensive care was examined by questionnaire. Sixty-one units (87 per cent) responded. Fifty-nine per cent of units used drugs for this purpose very commonly (more than once a week) and 26 per cent used them commonly (more than once a month). The commonest indication was to provide analgesia and/or sedation during mechanical ventilation, but drugs were frequently used in post-operative pain relief, in necrotising enterocolitis, for fractures and in meningitis, as well as for several less common indications. Opiates were widely used, particularly morphine (77 per cent of units), diamorphine (31 per cent), fentanyl (16 per cent) and pethidine (16 per cent). They were administered by bolus injection or continuous infusion, usually intravenously. The range of doses used, especially for morphine and diamorphine, was wide and adverse effects (cardiovascular, respiratory, bowel and bladder) were commonly reported (48 per cent). Non-opiate drugs, especially chloral hydrate and paracetamol, were commonly used, too; adverse effects were rarely reported. There is a need to examine the most effective and safest ways of adminstering analgesia and sedation, particularly opiates, to the newborn.