Neonatal Pain

[email_address] KAREEM EL- BASSIOUNY AWAD UNDER HELPFUL SUPERVISION OF: PROF. DR. SHADIA EL- SALLAB

Definition ,[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Outdated professional attitudes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

The Fact ,[object Object],[object Object],[email_address]

The Fact ,[object Object],[object Object],[object Object],[email_address]

Developmental Aspects of Pain Perception ,[object Object],[object Object],[object Object],[email_address]

Pain Pathways Descending pathways Ascending pathways Peripheral receptors Neural pathways Spinal cord tracts Brainstem, thalamus, & beyond [email_address]

Anatomic developments [email_address]

Physiologic Development ,[object Object],[object Object],[object Object],[object Object],: [email_address]

The Effects of Pain [email_address] Kareem Awad

Immediate Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Long Term Effects of Untreated Pain ,[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Long Term Effects of Untreated Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

[object Object],[email_address] Kareem Awad

Painful Procedures in NICU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

How the newborn responds to Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Kareem Awad

Physiologic/autonomic responses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Behavioral Cues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Hormonal/Metabolic Responses ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Hormonal/Metabolic Responses ,[object Object],[object Object],[object Object],[object Object]

Factors Affecting Pain Response ,[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Factors leading to the development of assessment and treatment of pain ,[object Object],[object Object],[object Object],[email_address]

[email_address] “ Because neonates cannot verbalize their pain, they depend on others to recognize, assess, manage their pain.” Prevention and Management of Pain and Stress in the Neonate (RE9945) -- Pediatrics Volume 105, Number 2 February 2000, pp 454-461

Assessment of Pain ,[object Object],[object Object],[object Object],[email_address] Kareem Awad

Common Pain scales [email_address]

ABC scale for pain in newborns ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

ABC scale for pain in newborns [email_address]

Prevention of neonatal pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

[email_address] ,[object Object]

Non Pharmacological Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Non-Pharmacological Treatment [email_address]

Environmental Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Swaddling, Positioning and Touch ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Nonnutritive Suckling “NNS” ,[object Object],[object Object],[object Object],[email_address]

SUCROSE ,[object Object],[object Object],[object Object],[email_address] Kareem Awad

Effect of Oral Sucrose Solution on Venipuncture Pain Abad, et al Acta Paediatr, 1996 Time crying (sec) [email_address]

Effect of sucrose on circumcision pain AJOG 2002;186:564-8 [email_address]

SUCROSE ,[object Object],[object Object],[email_address] Kareem Awad

SUCROSE ;dose ,[object Object],[object Object],[object Object],[object Object],[email_address]

SUCROSE; repeated doses ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Sucrose; side effects ,[object Object],[object Object],[object Object],[email_address]

GLUCOSE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Multisensory Stimulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Multisensory stimulation plus oral glucose ,[object Object],[object Object],[email_address]

Skin to skin contact ( kangaroo care ) ,[object Object],[email_address]

Contact Control Skin-skin contact Gray, et al Pediatrics 2000 Percent of time [email_address]

Breast feeding ,[object Object],[object Object],[object Object],[email_address] Kareem Awad

Breast milk ,[object Object],[object Object],[object Object],[email_address]

Music therapy “ MT ” ,[object Object],[object Object],[object Object],[object Object],[email_address]

Pharmacologic analgesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Local analgesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Local analgesia ,[object Object],[object Object],[object Object],[object Object],[email_address]

Nonnarcotic drugs ,[object Object],[object Object],[object Object],[email_address]

Narcotic drugs ,[object Object],[object Object]

Narcotic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Morphine Fentanyl

Recommended analgesic doses for neonates [email_address]

Adverse effects of analgesic agents in neonates [email_address]

Heel lance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Percutaneous venous catheter insertion & venipuncture ,[object Object],[object Object],[object Object],[object Object],[email_address]

UVC & UAC insertion ,[object Object],[object Object],[object Object],[email_address]

PICC insertion ,[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

Central venous line placement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Peripheral arterial or venous cut down ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Lumbar puncture ,[object Object],[object Object],[object Object],[email_address] Kareem Awad

SC or IM injection ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

ETT insertion ,[object Object],[object Object],[object Object],[email_address]

ETT insertion ,[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

ETT suction ,[object Object],[object Object],[object Object],[email_address]

Nasogastric or orogastric tube insertion ,[object Object],[object Object],[object Object],[email_address]

Chest tube insertion ,[object Object],[object Object],[object Object],[object Object],[email_address]

Circumcision ,[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Ongoing analgesia for routine NICU care and procedures ,[object Object],[object Object],[object Object],[email_address] Kareem Awad

Future perspectives. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address]

Important to know ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[email_address] Kareem Awad

[email_address] Kareem Awad THANK YOU

Neonatal Pain

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Neonatal Pain

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