title: Utilization of analgesics, sedatives, and pain scores in infants with a prolonged hospitalization: a prospective descriptive cohort study.
abstract: OBJECTIVE
  Describe the utilization of analgesic and sedative medications and documentation of pain scores in a cohort of critically ill infants in a neonatal intensive care unit.
  
  
  METHODS
  A prospective, longitudinal, cohort study of infants with a predicted length of stay > or =28 days. Dosages and routes of administration of analgesic and sedative medications and documentation of pain scores were collected on a daily basis.
  
  
  RESULTS
  55 infants were enrolled into the study. Oral sucrose was administered to all 55 infants, 51 infants (93%) were administered enteral acetaminophen and 50 (91%) infants were administered morphine during their hospitalization. Sedatives were administered to 42 infants (76%); 36 (65%) were administered chloral hydrate and 32 (58%) were administered intravenous midazolam. With the exception of the first week of admission, when there was highest utilization of opioids and lower use of sucrose, acetaminophen and sedatives, the pattern of administration of analgesic and sedative agents remained relatively constant throughout the hospitalization. Pain scores were documented for 36 (65%) infants during their hospitalisation, however for these 36 infants, pain scores were infrequently recorded.
  
  
  CONCLUSIONS
  There was substantial and varied analgesic and sedative use in this cohort of infants, yet infrequent documentation of pain assessment scores. These practices highlight important clinical implications for sick infants requiring careful consideration of pain and distress management.
authors.affiliation: School of Nursing, The University of Melbourne, Australia. denise.harrison@utoronto.ca
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
authors.forename: Peter
authors.initials: P
authors.lastname: Loughnan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.forename: Linda
authors.initials: L
authors.lastname: Johnston
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D015331:Cohort Studies; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007902:Length of Stay; D010147:Pain Measurement
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives