CHANGING ATTITUDES AND PRACTICE OF PAIN RELIEF FOR COMMONLY PERFORMED NEONATAL PROCEDURES

Fernando A.M.R.1 Heaton P.A.J.1, Herd D.W.2

1Taranaki Base Hospital, New Plymouth, New Zealand

2Waikato Hospital, Hamilton, New Zealand

 

Objective: To evaluate changes, over 2 years, in attitudes and practice of pain relief for commonly performed procedures (PRCPP) in New Zealand neonatal units.

Methods: A structured questionnaire with analogue rating scale was sent to the medical directors of the 18 New Zealand neonatal units in 1999 and 2001.

Results: 1999: Of 15 replies, all agreed that procedures (including venepuncture, heel prick and arterial puncture) caused pain. 5 had used analgesia, usually for less than 10% of procedures; only 1 unit used oral sucrose routinely. 10 thought physiological risk of pain was greater than risk of analgesia; 13 agreed oral sucrose was a safe and effective analgesic.

2001: Of 11 replies, all agreed that PRCPP was important. PRCPP was used in 4 units for 10-90% of procedures, of which 3 units used oral sucrose. Most agreed that families, nurses and junior doctors were not opposed to PRCPP, but that there was little demand for use from those performing the procedures. Oral sucrose for PRCPP was thought safe, effective and rapid in action by most. Factors considered to increase use of oral sucrose for PRCPP (10 responses) included demand from nurses (9 units) and families (8 units), more evidence of efficacy (7 units) and safety (7 units), and for 8 units the commercial availability of an oral sucrose preparation.

Conclusion: There was increasing use of PRCPP, particularly oral sucrose, during the study period. More evidence of efficacy and safety along with increased demand from families and nurses would be likely to increase usage.

 

 

 
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