Pain management in neonates.

Recent research suggests that infants may be more vulnerable to the negative effects of pain than older children and adults. Apart from short-term effects, untreated pain and stressful stimuli may also have long-term effects, which may later affect their neurological development, including the reaction to pain. The preterm neonate is at especially high risk. Despite convincing evidence from recent research of the necessity to treat pain and to avoid early exposure to pain, the neonate is still subjected to painful procedures and even surgery without adequate pain treatment. This inadequacy could be due to insecurity regarding the pharmacokinetics and pharmacodynamics of pain-related drugs, to a limited understanding of the pain behaviour and pain physiology and the lack of appropriate measurement tools. The present paper reviews recent research in relation to management of pain in the newborn and considers implications for practice and future studies.