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• W4362522182 abstract "Neonates are an extremely vulnerable patient population, with 6% to 9% admitted to the neonatal intensive care unit (NICU) following birth. Neonates admitted to the NICU will undergo multiple painful procedures per day throughout their stay. There is increasing evidence that frequent and repetitive exposure to painful stimuli is associated with poorer outcomes later in life. To date, a wide variety of pain control mechanisms have been developed and implemented to address procedural pain in neonates. This review focused on non-opioid analgesics, specifically non-steroidal anti-inflammatory drugs (NSAIDs) and N-methyl-D-aspartate (NMDA) receptor antagonists, which alleviate pain through inhibiting cellular pathways to achieve analgesia. The analgesics considered in this review show potential for pain relief in clinical practice; however, an evidence summation compiling the individual drugs they comprise and outlining the benefits and harms of their administration is lacking. We therefore sought to summarize the evidence on the level of pain experienced by neonates both during and following procedures; relevant drug-related adverse events, namely episodes of apnea, desaturation, bradycardia, and hypotension; and the effects of combinations of drugs. As the field of neonatal procedural pain management is constantly evolving, this review aimed to ascertain the scope of non-opioid analgesics for neonatal procedural pain to provide an overview of the options available to better inform evidence-based clinical practice. OBJECTIVES: To determine the effects of non-opioid analgesics in neonates (term or preterm) exposed to procedural pain compared to placebo or no drug, non-pharmacological intervention, other analgesics, or different routes of administration.We searched the Cochrane Library (CENTRAL), PubMed, Embase, and two trial registries in June 2022. We screened the reference lists of included studies for studies not identified by the database searches.We included all randomized controlled trials (RCTs), quasi-RCTs, and cluster-RCTs in neonates (term or preterm) undergoing painful procedures comparing NSAIDs and NMDA receptor antagonists to placebo or no drug, non-pharmacological intervention, other analgesics, or different routes of administration. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our main outcomes were pain assessed during the procedure and up to 10 minutes after the procedure with a validated scale; episodes of bradycardia; episodes of apnea; and hypotension requiring medical therapy.We included two RCTs involving a total of 269 neonates conducted in Nigeria and India. NMDA receptor antagonists versus no treatment, placebo, oral sweet solution, or non-pharmacological intervention One RCT evaluated using oral ketamine (10 mg/kg body weight) versus sugar syrup (66.7% w/w at 1 mL/kg body weight) for neonatal circumcision. The evidence is very uncertain about the effect of ketamine on pain score during the procedure, assessed with the Neonatal Infant Pain Scale (NIPS), compared with placebo (mean difference (MD) -0.95, 95% confidence interval (CI) -1.32 to -0.58; 1 RCT; 145 participants; very low-certainty evidence). No other outcomes of interest were reported on. Head-to-head comparison of different analgesics One RCT evaluated using intravenous fentanyl versus intravenous ketamine during laser photocoagulation for retinopathy of prematurity. Neonates receiving ketamine followed an initial regimen (0.5 mg/kg bolus 1 minute before procedure) or a revised regimen (additional intermittent bolus doses of 0.5 mg/kg every 10 minutes up to a maximum of 2 mg/kg), while those receiving fentanyl followed either an initial regimen (2 μg/kg over 5 minutes, 15 minutes before the procedure, followed by 1 μg/kg/hour as a continuous infusion) or a revised regimen (titration of 0.5 μg/kg/hour every 15 minutes to a maximum of 3 μg/kg/hour). The evidence is very uncertain about the effect of ketamine compared with fentanyl on pain score assessed with the Premature Infant Pain Profile-Revised (PIPP-R) scores during the procedure (MD 0.98, 95% CI 0.75 to 1.20; 1 RCT; 124 participants; very low-certainty evidence); on episodes of apnea occurring during the procedure (risk ratio (RR) 0.31, 95% CI 0.08 to 1.18; risk difference (RD) -0.09, 95% CI -0.19 to 0.00; 1 study; 124 infants; very low-certainty evidence); and on hypotension requiring medical therapy occurring during the procedure (RR 5.53, 95% CI 0.27 to 112.30; RD 0.03, 95% CI -0.03 to 0.10; 1 study; 124 infants; very low-certainty evidence). The included study did not report pain score assessed up to 10 minutes after the procedure or episodes of bradycardia occurring during the procedure. We did not identify any studies comparing NSAIDs versus no treatment, placebo, oral sweet solution, or non-pharmacological intervention or different routes of administration of the same analgesics. We identified three studies awaiting classification. AUTHORS' CONCLUSIONS: The two small included studies comparing ketamine versus either placebo or fentanyl, with very low-certainty evidence, rendered us unable to draw meaningful conclusions. The evidence is very uncertain about the effect of ketamine on pain score during the procedure compared with placebo or fentanyl. We found no evidence on NSAIDs or studies comparing different routes of administration. Future research should prioritize large studies evaluating non-opioid analgesics in this population. As the studies included in this review suggest potential positive effects of ketamine administration, studies evaluating ketamine are of interest. Furthermore, as we identified no studies on NSAIDs, which are widely used in older infants, or comparing different routes of administration, such studies should be a priority going forward." @default.
• W4362522182 created "2023-04-06" @default.
• W4362522182 creator A5051439307 @default.
• W4362522182 creator A5051856158 @default.
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• W4362522182 date "2023-04-04" @default.
• W4362522182 modified "2023-10-09" @default.
• W4362522182 title "Non-opioid analgesics for procedural pain in neonates" @default.
• W4362522182 cites W1484474808 @default.
• W4362522182 cites W1572625196 @default.
• W4362522182 cites W1804744066 @default.
• W4362522182 cites W1806683282 @default.
• W4362522182 cites W1830337612 @default.
• W4362522182 cites W1957857943 @default.
• W4362522182 cites W1969228538 @default.
• W4362522182 cites W1989803413 @default.
• W4362522182 cites W2000966423 @default.
• W4362522182 cites W2002254477 @default.
• W4362522182 cites W2005564844 @default.
• W4362522182 cites W2013253407 @default.
• W4362522182 cites W2014534817 @default.
• W4362522182 cites W2017422474 @default.
• W4362522182 cites W2027760784 @default.
• W4362522182 cites W2046224781 @default.
• W4362522182 cites W2048973207 @default.
• W4362522182 cites W2049073164 @default.
• W4362522182 cites W2066148894 @default.
• W4362522182 cites W2068962162 @default.
• W4362522182 cites W2070297403 @default.
• W4362522182 cites W2084119556 @default.
• W4362522182 cites W2098173805 @default.
• W4362522182 cites W2098886949 @default.
• W4362522182 cites W2103043076 @default.
• W4362522182 cites W2112261155 @default.
• W4362522182 cites W2113760558 @default.
• W4362522182 cites W2117425969 @default.
• W4362522182 cites W2117863998 @default.
• W4362522182 cites W2130172037 @default.
• W4362522182 cites W2153388030 @default.
• W4362522182 cites W2156098321 @default.
• W4362522182 cites W2299177375 @default.
• W4362522182 cites W2301034803 @default.
• W4362522182 cites W2332449635 @default.
• W4362522182 cites W2416711069 @default.
• W4362522182 cites W2468996569 @default.
• W4362522182 cites W2548088260 @default.
• W4362522182 cites W2601885813 @default.
• W4362522182 cites W2604568423 @default.
• W4362522182 cites W27575541 @default.
• W4362522182 cites W2885562735 @default.
• W4362522182 cites W2920380976 @default.
• W4362522182 cites W2968908162 @default.
• W4362522182 cites W3015764967 @default.
• W4362522182 cites W3022590921 @default.
• W4362522182 cites W3048480974 @default.
• W4362522182 cites W3095902429 @default.
• W4362522182 cites W3108696194 @default.
• W4362522182 cites W3125296572 @default.
• W4362522182 cites W3151327446 @default.
• W4362522182 cites W3199030363 @default.
• W4362522182 cites W3206236979 @default.
• W4362522182 cites W4200194082 @default.
• W4362522182 cites W4230226028 @default.
• W4362522182 cites W4231892373 @default.
• W4362522182 cites W4238227833 @default.
• W4362522182 cites W4248609164 @default.
• W4362522182 cites W4285389626 @default.
• W4362522182 cites W4294168469 @default.
• W4362522182 cites W4308934764 @default.
• W4362522182 cites W4362522182 @default.
• W4362522182 cites W4362656975 @default.
• W4362522182 doi "https://doi.org/10.1002/14651858.cd015179.pub2" @default.
• W4362522182 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37014033" @default.
• W4362522182 hasPublicationYear "2023" @default.
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