Table 15

New recommendations regarding pain, analgesia and neuromuscular blockade management in CDH143–147 149 150

New recommendationsStrength of consensusLevel of evidence
15.1 All infants with CDH requiring mechanical ventilation should have personalised analgesic/sedation management that is guided by a clinically applicable and appropriately validated pain/sedation scoring tool.4B-NR
15.2 Intravenous opioid (morphine or fentanyl) should be administered as a CI in combination with a short-acting benzodiazepine, which may reduce opioid dosing requirements.3B-NR
15.3 Routine neuromuscular blockade should be avoided in preoperative stabilisation, but its use should be considered for infants with escalating severity of pulmonary hypertension or if ventilation targets are difficult to achieve.4C-LD
15.4 Postoperative use of intravenous acetaminophen should be considered as a means of reducing overall opioid requirements.3B-NR
  • CDH, congenital diaphragmatic hernia; CI, continuous infusion; LD, limited data; NR, non-randomised.