Neonatal Pain Case Study

Infants receiving care in the Neonatal Intensive Care Unit (NICU) might experience up to several hundred painful procedures during their stay \cite{cruz2016epidemiology}. Pediatric studies have reported several long-term outcomes of repeated pain exposure in early life. For instance, it has been found \cite{grunau2006long} that repeated painful experience in neonates is associated with alterations in the cerebral white matter and subcortical grey matter and delayed cortico-spinal development. These alterations in neurodevelopment can result in a variety of behavioral, developmental and learning disabilities \cite{grunau2006long}. Other long-term outcomes of pain exposure that are reported \cite{field2017preterm} at school age include delayed visual–perceptual development, lower IQs, and internalizing behavior. …show more content…
Although analgesic medications can reduce the consequences of neonatal pain exposure, recent studies found a link between the excessive use of these medications and many short- and long-term side effects. Zwicker et al. \cite{zwicker2016smaller} found that 10-fold increase in Morphine, an agent commonly used for neonatal pain management, is associated with impaired cerebellar growth in the neonatal period and poorer neurodevelopmental outcomes in early childhood period. The long-term side effects of another well-known analgesic medication (i.e., Fentanyl) were discussed in \cite{tam2011preterm}. This study described Fentanyl as an extremely potent analgesic and listed several side effects, such as neuroexcitation, respiratory depression, for using high doses of