Pain management in Swedish neonatal units--a national survey.
OBJECTIVE
The aim of this study was to investigate the degree to which Swedish neonatal units have adopted the national guidelines for prevention and treatment of pain in newborn infants.


METHODS
A survey was sent to all units in Sweden that provide neonatal care. For a list of potentially painful procedures, compiled from the national neonatal pain guidelines, the units were asked if they would use pharmacological and/or behavioural interventions, and in each case to specify the treatment.


RESULTS
The response rate was 80.4%. Eighty-eight percent of the units had written guidelines for pain management, and 59% of these had been updated within the last 2 years. For almost every presented case, all units reported that they used either pharmacological or behavioural treatment or both. The survey showed a wide variation in morphine and paracetamol dosing and the absence of a paracetamol loading dose in a fourth of the units.


CONCLUSIONS
This study suggests that a majority of Swedish neonatal units have adopted pain management guidelines in concordance with the Swedish national guidelines, and kept them up-to-date. For most painful situations a variety of behavioural and pharmacological interventions are used, often in combination.
Eriksson
Mats
M
Department of Paediatrics, Orebro University Hospital, Orebro, Sweden. mats.eriksson@orebroll.se
Gradin
Maria
M
D000082:Acetaminophen / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D003625:Data Collection; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009020:Morphine / Q000627:therapeutic use; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management; D013548:Sweden
D000700:Analgesics; D000082:Acetaminophen; D009020:Morphine