Safety concerns over the potential neurotoxicity of sedatives and analgesics in neonates, often used in neonatal intensive care units (NICUs) for pain relief, have raised questions at an international level.
The EUROPAIN (EUROpean Pain Audit In Neonates) prospective cohort study aimed to describe the current use of sedation and analgesia among 6,680 neonates in 243 NICUs in 18 European countries.
Sedation and analgesia use ranged from 0% to 100%; 34% of all neonates and 82% of neonates who were tracheally ventilated (TV) received sedation or analgesia. Around three-quarters of TV neonates were given opioids.
Writing in Lancet Respiratory Medicine (online, 24 September 2015)
, the authors warn that opioids may prolong the need for ventilation in TV neonates. They encourage further research and the development of international guidelines to promote safer use of sedatives and analgesics.
 Carbajal R, Eriksson M, Courtois E et al. Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): results from a prospective cohort study. Lancet Respiratory Medicine 2015. doi.org/10.1016/S2213-2600(15)00331â8