Summary proceedings from the neonatal pain-control group.
Recent advances in neurobiology and clinical medicine have established that the fetus and newborn may experience acute, established, and chronic pain. They respond to such noxious stimuli by a series of complex biochemical, physiologic, and behavioral alterations. Studies have concluded that controlling pain experience is beneficial with respect to short-term and perhaps long-term outcomes. Yet, pain-control measures are adopted infrequently because of unresolved scientific issues and lack of appreciation for the need for control of pain and its long-term sequelae during the critical phases of neurologic maturation in the preterm and term newborn. The neonatal pain-control group, as part of the Newborn Drug Development Initiative (NDDI) Workshop I, addressed these concerns. The specific issues addressed were (1) management of pain associated with invasive procedures, (2) provision of sedation and analgesia during mechanical ventilation, and (3) mitigation of pain and stress responses during and after surgery in the newborn infant. The cross-cutting themes addressed within each category included (1) clinical-trial designs, (2) drug prioritization, (3) ethical constraints, (4) gaps in our knowledge, and (5) future research needs. This article provides a summary of the discussions and deliberations. Full-length articles on procedural pain, sedation and analgesia for ventilated infants, perioperative pain, and study designs for neonatal pain research were published in Clinical Therapeutics (June 2005).
Anand
Kanwaljeet J S
KJ
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. anandsunny@uams.edu
Aranda
Jacob V
JV
Berde
Charles B
CB
Buckman
ShaAvhrée
S
Capparelli
Edmund V
EV
Carlo
Waldemar
W
Hummel
Patricia
P
Johnston
C Celeste
CC
Lantos
John
J
Tutag-Lehr
Victoria
V
Lynn
Anne M
AM
Maxwell
Lynne G
LG
Oberlander
Tim F
TF
Raju
Tonse N K
TN
Soriano
Sulpicio G
SG
Taddio
Anna
A
Walco
Gary A
GA
D000698:Analgesia; D000768:Anesthesia, General; D002986:Clinical Trials as Topic / Q000941:ethics* / Q000331:legislation & jurisprudence; D033161:Government Regulation; D006801:Humans; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care / Q000379:methods; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D012121:Respiration, Artificial / Q000009:adverse effects; D014481:United States