Pharmacologic Analgesia and Sedation in Neonates

Chronic pain and agitation in neonatal life impact the developing brain. Oral sweet-tasting solutions should be used judiciously to mitigate behavioral responses to mild painful procedures, keeping in mind that the long-term impact is unknown. Rapidly acting opioids should be used as part of premedication cocktails for nonemergent endotracheal intubations. Continuous low-dose morphine or dexmedetomidine may be considered for preterm or term neonates exhibiting signs of stress during mechanical ventilation and therapeutic hypothermia, respectively. Further research is required regarding the pharmacokinetics, pharmacodynamics, safety, and efficacy of pharmacologic agents used to mitigate mild, moderate, and chronic pain and stress in neonates.

Automated summary

Chronic pain and agitation in neonates can affect brain development. Oral sweet-tasting solutions should be used carefully to alleviate behavioral responses to mild pain, with the understanding that long-term effects are unknown. Rapid-acting opioids are recommended for premedication in non-emergent endotracheal intubations. Continuous low-dose morphine or dexmedetomidine can be considered for preterm or term neonates experiencing stress during mechanical ventilation or therapeutic hypothermia. Further research is needed on the pharmacokinetics, pharmacodynamics, safety, and efficacy of pharmacological agents for managing mild, moderate, and chronic pain and stress in neonates.