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We conducted a survey of neonatal pain relief practices for common procedures across the United Kingdom as a baseline for improving our own practice, and we here present the results.
We sent a questionnaire to all Scottish hospitals, and units from the rest of the United Kingdom if they had 40 or more maternity beds (n = 96);1 the response rate was 85%. Analgesia was used in 82% of units for elective intubation, the commonest agent used being morphine (79%), followed by fentanyl. Analgesia was also used in 11% of the units for intravenous cannulation and in 10% for heelpricks. The analgesia most commonly used for cannulation was sucrose or dextrose. Some 5% of units stated that they used morphine for radial arterial lines but these infants were already ventilated and receiving morphine.
These data appear to give a snapshot of current practice, but we cannot know how far unit guidelines translated into the actual experience of the babies. As pain in the neonatal period has immediate and long term consequences,1,2 and preterm infants may be exposed to many painful procedures during their hospital stay, there is some way to go before we can claim that neonates are getting optimum pain control.1,2 The wider use of sucrose and topical anaesthetics (if safety concerns can be adequately addressed) seem likely to be the quickest routes to improving the situation.
Acknowledgments
We thank all the neonatal units who participated in this survey.