Infants Operated on for Necrotizing Enterocolitis: Towards Evidence-Based Pain Guidelines

Naomi Meesters, Monique van Dijk, CAJ Knibbe, Claudia Keyzer - Dekker, Dick Tibboel, SHP (Sinno) Simons

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
2 Downloads (Pure)

Abstract

Background: Necrotizing enterocolitis (NEC) is known as an extremely painful childhood condition. Objectives: The objective of this study was to explore pain management around NEC-related surgery in our neonatal intensive care unit (NICU) from a chart review of prospectively collected data on 60 operated NEC patients admitted between 2008 and 2013 with a median (IQR) gestational age of 28.3 (25.5-31.6) weeks. Methods: Pain medication data and pain scores (i.e. COMFORTneo and Numerical Rating Scale pain and distress scores) from 72 h before until 72 h after surgery were collected. Results: Preoperatively, 95% of the patients received morphine versus 100% postoperatively, with a median dosage of 10.0 (IQR 9.7-14.5) and 16.9 (IQR 10.1-20.0) mu g/kg/h, respectively. Postoperatively, 28 patients (46.7%) received additional fentanyl intermittently and 14 (23.3%) received midazolam, which was part of palliative treatment for 6 patients (42.9%). In patients receiving pain medication, median COMFORTneo scores were 10 (IQR 10-11) preoperatively and 11 (10-12) postoperatively. The pain scores were comparable with those of other patients admitted to the NICU in the same time period. Conclusions: Continuous morphine of 10 mu g/kg/h preoperatively, with an increase to 15 g/kg/h postoperatively, seems to constitute a good starting dose for further individualized pain management guided by pain scores. (C) 2016 The Author(s) Published by S. Karger AG, Basel
Original languageUndefined/Unknown
Pages (from-to)190-197
Number of pages8
JournalNeonatology
Volume110
Issue number3
DOIs
Publication statusPublished - 2016

Cite this