title: Acute perioperative pain in neonates: An evidence-based review of neurophysiology and management.
abstract: Current literature lacks systematic data on acute perioperative pain management in neonates and mainly focuses only on procedural pain management. In the current review, the neurophysiological basis of neonatal pain perception and the role of different analgesic drugs and techniques in perioperative pain management in neonates are systematically reviewed. Intravenous opioids such as morphine or fentanyl as either intermittent bolus or continuous infusion remain the most common modality for the treatment of perioperative pain. Paracetamol has a promising role in decreasing opioid requirement. However, routine use of ketorolac or other nonsteroidal anti-inflammatory drugs is not usually recommended. Epidural analgesia is safe in experienced hands and provides several benefits over systemic opioids such as early extubation and early return of bowel function.
authors.affiliation: Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Souvik
authors.initials: S
authors.lastname: Maitra
authors.affiliation: Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India. Electronic address: dalimkumarb001@yahoo.co.in.
authors.forename: Dalim Kumar
authors.initials: DK
authors.lastname: Baidya
authors.affiliation: Department of Anesthesiology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Khanna
authors.affiliation: Department of Anesthesiology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Bikash Ranjan
authors.initials: BR
authors.lastname: Ray
authors.affiliation: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shasanka Shekhar
authors.initials: SS
authors.lastname: Panda
authors.affiliation: Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Minu
authors.initials: M
authors.lastname: Bajpai
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D000208:Acute Disease; D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000767:Anesthesia, Epidural / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D055770:Interpleural Analgesia; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management / Q000379:methods*; D059035:Perioperative Period; D011182:Postoperative Care
chemical_list: D000701:Analgesics, Opioid; D000082:Acetaminophen
keywords: analgesia, epidural; analgesics, opioid; infant, newborn; pain, postoperative