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Pediatrics 2000, 105:454-61. American Academy of Pediatrics, Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, Section on Surgery Canadian Paediatric Society, Fetus and Newborn Committee

Review: This statement from the American Academy of Pediatrics and Canadian Paediatric Society is intended for all who care for neonates, defined as the time from birth to 28 days of post natal life. The statement was developed with input from over 50 of experts in the care of the newborn. The paper reviews much of the landmark work done in the study of pain and stress in the neonate and much of the focus is naturally on the perioperative period.

Comments: It is worth having a copy of the paper for its 110 references. In addition to perioperative concerns, the evaluation of the experience of non painful stress in these patients is discussed. A copy of this report should be in all of our files, posted prominently in nurseries, operating rooms and other areas in the hospital where newborns receive care. The statement recommends, among other things, that adequate expertise and monitoring be in place to allow the safe administration of pharmacologic agents to newborns as part of management of their pain and stress. As advocates for children, we can use the recommendations to work for institutional policies to assess, prevent and manage pain in neonates and to provide professional education in these areas.

Reviewed by: Thomas J Mancuso, MD, FAAP
Childrens Hospital, Boston