title: [Sedation and analgesia practices among Spanish neonatal intensive care units].
abstract: BACKGROUND
  Pain management and sedation is a priority in neonatal intensive care units. A study was designed with the aim of determining current clinical practice as regards sedation and analgesia in neonatal intensive care units in Spain, as well as to identify factors associated with the use of sedative and analgesic drugs.
  
  
  METHODS
  A multicenter, observational, longitudinal and prospective study.
  
  
  RESULTS
  Thirty neonatal units participated and included 468 neonates. Of these, 198 (42,3%) received sedatives or analgesics. A total of 19 different drugs were used during the study period, and the most used was fentanyl. Only fentanyl, midazolam, morphine and paracetamol were used in at least 20% of the neonates who received sedatives and/or analgesics. In infusions, 14 different drug prescriptions were used, with the most frequent being fentanyl and the combination of fentanyl and midazolam. The variables associated with receiving sedation and/or analgesia were, to have required invasive ventilation (P<.001; OR=23.79), a CRIB score >3 (P=.023; OR=2.26), the existence of pain evaluation guides in the unit (P<.001; OR=3.82), and a pain leader (P=.034; OR=2.35).
  
  
  CONCLUSIONS
  Almost half of the neonates admitted to intensive care units receive sedatives or analgesics. There is significant variation between Spanish neonatal units as regards sedation and analgesia prescribing. Our results provide evidence on the "state of the art", and could serve as the basis of preparing clinical practice guidelines at a national level.
authors.affiliation: Unidad de Neonatología, Servicio de Pediatría, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), A Coruña, España. Electronic address: alejandro.avila.neonatologia@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Avila-Alvarez
authors.affiliation: Service d'Urgences Pédiatriques, Hôpital d'enfants Armand Trousseau, Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Université Pierre et Marie Curie, París, Francia.
authors.forename: R
authors.initials: R
authors.lastname: Carbajal
authors.affiliation: Service d'Urgences Pédiatriques, Hôpital d'enfants Armand Trousseau, Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Université Pierre et Marie Curie, París, Francia.
authors.forename: E
authors.initials: E
authors.lastname: Courtois
authors.affiliation: Grupo de Investigación de Epidemiología Clínica y Bioestadística, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), A Coruña, España.
authors.forename: S
authors.initials: S
authors.lastname: Pertega-Diaz
authors.affiliation: Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), A Coruña, España.
authors.forename: J
authors.initials: J
authors.lastname: Muñiz-Garcia
authors.affiliation: University of Tennessee Health Science Center, Menphis, Estados Unidos.
authors.forename: K J S
authors.initials: KJ
authors.lastname: Anand
mesh_terms: D000698:Analgesia; D000700:Analgesics / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008137:Longitudinal Studies; D059408:Pain Management / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012121:Respiration, Artificial; D013030:Spain
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives
keywords: Analgesia; Dolor; Neonate; Neonato; Pain; Sedación; Sedation