title: Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy.
abstract: BACKGROUND
  The aim of this survey was to evaluate the current practice regarding pain assessment and pain management strategies adopted in commonly performed minor painful procedures in Northern Italian Neonatal Intensive Care Units (NICUs).
  
  
  METHODS
  A multicenter survey was conducted between 2008 and 2009 in 35 NICUs. The first part of the survey form covered pain assessment tools, the timing of analgesics, and the availability of written guidelines. A second section evaluated the analgesic strategies adopted in commonly performed painful procedures. The listed analgesic procedures were as follows: oral sweet solutions alone, non-nutritive sucking (NNS) alone, a combination of sweet solutions and NNS, breast-feeding where available, and topical anesthetics.
  
  
  RESULTS
  Completed questionnaires were returned from 30 neonatal units (85.7% response rate). Ten of the 30 NICUs reported using pain assessment tools for minor invasive procedures. Neonatal Infant Pain Scale was the most frequently used pain scale (60%). Twenty neonatal units had written guidelines directing pain management practices. The most frequently used procedures were pacifiers alone (69%), followed by sweet-tasting solutions (58%). A 5% glucose solution was the most frequently utilized sweet-tasting solution (76.7%). A minority of NICUs (16.7%) administered 12% sucrose solutions for analgesia and the application of topical anesthetics was found in 27% of NICUs while breast-feeding was performed in 7% of NICUs.
  
  
  CONCLUSIONS
  This study found a low adherence to national and international guidelines for analgesia in minor procedures: the underuse of neonatal pain scales (33%), sucrose solution administration before heel lance (23.3%), topical anesthetics before venipuncture, or other analgesic techniques. The presence of written pain control guidelines in these regions of Northern Italy increased in recent years (from 25% to 66%).
authors: Department of Anaesthesia and Intensive Care, Agnelli Hospital, Pinerolo, Italy. luigi.codipietro@yahoo.it
authors: Luigi
authors: L
authors: Codipietro
authors: Elena
authors: E
authors: Bailo
authors: Marco
authors: M
authors: Nangeroni
authors: Alberto
authors: A
authors: Ponzone
authors: Giuseppe
authors: G
authors: Grazia
mesh_terms: D000698:Analgesia / Q000379:methods* / Q000639:trends; D000772:Anesthesia, Local / Q000379:methods* / Q000639:trends; D003625:Data Collection / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000639:trends; D007558:Italy / Q000453:epidemiology; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D059408:Pain Management; D018962:Phlebotomy / Q000009:adverse effects / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires / Q000592:standards