RCPCH Conference 2019: Paediatric Pain Management

Dr Laura Price

This talk focused on Dr Rebeccah Slaters work on how noxious information is transmitted to the neonatal brain.
Her research focuses on how the brain behaves at rest and then differs with noxious activity  with the aim of improving neonatal pain management. Throughout the discussion the speakers explored how to assess pain in neonates such as scoring systems and assessing facial expressions; although this is much harder in more preterm infants.  Speakers then suggested possible analgesics such as sucrose, morphine, fentanyl or light touch.
Dr Slater discussed her POPPI trial - which assessed if morphine was a suitable analgesic for ROP screening in infants however this trial was quickly stopped due to safety concerns.

The rest of the discussion then focused on ethical issues surrounding pain management for example in patients with HIE, those requiring multiple and frequent blood tests or those having ROP.

This series of talks demonstrated the difficulty in assessing neonatal pain but also the rapidly increasing knowledge and evidence. It did raise the question of which analgesic is best and when it is needed with ongoing evidence hopefully able to answer this more.