O-101 Number Of Procedures And Analgesic Therapy In Neonates Admitted To Nicus: Epippain 2 Study

BackgroundNeonates admitted to NICUs are frequently subjected to invasive procedures, often with sub-optimal analgesic treatment.ObjectiveTo determine the number of invasive procedures and analgesic practices in NICUs.MethodsInvasive procedures and corresponding analgesic therapies on days 1–14 of NICU admission were prospectively studied over a 2-month period in all neonates admitted to the 16 NICUs in the Paris region.ResultsFor 589 neonates included, mean (SD) gestational age, birth weight, CRIB scores, and number of days of participation were 33.3 (4.5) wks, 1983 (943) gm, 1.5 (2.5), and 7.4 (4.5) days, respectively. 103239 procedures were performed in all neonates, 40927 were classified as painful and 62312 were stressful. The median (range) number of all procedures, painful procedures (PP) and stressful procedures (SP) per infant were, respectively, 124 (0–699), 44 (0–353), and 78 (0–406). Table 1 shows most frequent PP.Abstract O-101 Table 1Five more frequent painful procedures[Figure omitted. See PDF]Abstract O-101 Table 2Logistic regression models factor association with the use of analgesia during 40927 painful procedures in neonates, adjusted for centres[Figure omitted. See PDF]Analgesic therapy before PP varied widely among procedures. Analgesic therapy was given before 28.1% of PP. Continuous infusions of sedatives and/or analgesics were given during 38.8% of PP. Overall, 61.8% of PP were performed with an analgesic given before the procedures and/or while the neonate was receiving continuous sedation/analgesia. Fig. shows factors associated with preprocedural analgesia use.ConclusionsThere is an urgent need to reduce the number of procedures and the pain produced by routine NICU procedures in neonates. Analgesic therapy should be matched with the intensity and duration of acute pain caused by invasive procedures.