CHANGING ATTITUDES AND PRACTICE OF PAIN RELIEF FOR
COMMONLY PERFORMED NEONATAL PROCEDURES
Fernando
A.M.R.1 Heaton P.A.J.1, Herd D.W.2
1Taranaki
Base Hospital, New Plymouth, New Zealand
2Waikato
Hospital, Hamilton, New Zealand
Objective: To evaluate changes,
over 2 years, in attitudes and practice of pain relief for commonly
performed procedures (PRCPP) in New Zealand neonatal units.
Methods: A structured questionnaire
with analogue rating scale was sent to the medical directors of the 18 New
Zealand neonatal units in 1999 and 2001.
Results: 1999: Of 15 replies, all agreed that procedures (including
venepuncture, heel prick and arterial puncture) caused pain. 5 had used
analgesia, usually for less than 10% of procedures; only 1 unit used oral
sucrose routinely. 10 thought physiological risk of pain was greater than
risk of analgesia; 13 agreed oral sucrose was a safe and effective
analgesic.
2001: Of 11 replies, all agreed that PRCPP was important. PRCPP was
used in 4 units for 10-90% of procedures, of which 3 units used oral
sucrose. Most agreed that families, nurses and junior doctors were not
opposed to PRCPP, but that there was little demand for use from those
performing the procedures. Oral sucrose for PRCPP was thought safe,
effective and rapid in action by most. Factors considered to increase use
of oral sucrose for PRCPP (10 responses) included demand from nurses (9
units) and families (8 units), more evidence of efficacy (7 units) and
safety (7 units), and for 8 units the commercial availability of an oral
sucrose preparation.
Conclusion: There was increasing
use of PRCPP, particularly oral sucrose, during the study period. More
evidence of efficacy and safety along with increased demand from families
and nurses would be likely to increase usage.