Procedural Pain in Hospitalized Neonates in Kenya

Purpose: The study was conducted to understand the nature and frequency of painful procedures and use of analgesia in neonatal units in Kenya. Design and methods: Descriptive prospective study was conducted in a regional Level I and a university-affiliated Level II neonatal unit in Western Kenya. Two hundred term and preterm neonates who were hospitalized during the first day of life were recruited. A validated checklist was used to audit medical charts of hospitalized neonates. Painful procedures and pain treatment interventions accompanying all procedures performed during the first seven days of hospitalization were documented. Descriptive statistics, t-tests and chi(2) were used to determine frequency and factors influencing the frequency of procedures. Results: A total of 1693 painful procedures (mean = 1.6 +/- 1.1) were performed with most of them being tissue damaging (n=1291) including intravenous cannulation and intramuscular injection. Neonates were less likely to undergo procedures if there were born at term (RR 0.85; 95% CI, 0.76-0.95, p=.003) but more likely to experience procedures if admitted in a higher level of care (RR 1.57, 95% CI, 1.43-1.74, p<.001). Only one procedure was accompanied by analgesia. Conclusions: Neonates underwent few but highly invasive procedures without analgesia. Prematurity and a high level of care predisposed neonates to a higher burden of pain. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

The study in neonatal units in Kenya found that neonates underwent few but highly invasive procedures without analgesia, with preterm infants and those in higher level of care being more likely to experience pain.