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Pain Assessment and Pharmacologic Management for Infants with NEC: A Retrospective Chart Audit

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Purpose: To examine (1) the frequency and types of painful procedures, (2) the frequency and types of analgesic/sedative use, and (3) the frequency of documented pain assessments that infants experience during the five days following a diagnosis of necrotizing enterocolitis (NEC).

Design: A retrospective descriptive cohort design.

Sample: Thirty-nine infants from one tertiary care unit diagnosed with stage II NEC.

Main Outcome Variable: Painful procedure data were classified into highly invasive procedures and moderately invasive procedures and were collected for five days following the diagnosis of NEC. Frequency and types of analgesic/sedative administration and frequency of documented pain assessments during each of the five days following the NEC diagnosis were collected.

Results: The average number of painful procedures was 16.3 per day, with documented PIPP scores performed on 30–60 percent of the infants during each of the days following the diagnosis of NEC. At no time were more than two PIPP scores per infant documented in a 24-hour period. Analgesics were used in 52–76 percent of infants during the first three days following the diagnosis of NEC, but use decreased gradually on the fourth and fifth days. No correlation between painful procedures and analgesic/sedative administration on any day was found. Similarly, no correlation between documented PIPP scores and analgesic/sedative use on any day was found.

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Document Type: Research Article

Publication date: September 1, 2006

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