A Pilot Randomized Controlled Trial of Outcomes Associated with Parent-Nurse Controlled Analgesia vs. Continuous Opioid Infusion in the Neonatal Intensive Care Unit

Prospectively compare parent/nurse controlled analgesia (PNCA) to continuous opioid infusion (COI) in the post-operative neonatal intensive care unit (NICU) population. A randomized controlled trial compared neonates treated with morphine PNCA to those treated with morphine COI. The primary outcome...

Full description

Saved in:

Bibliographic Details
Published in:	Pain management nursing Vol. 21; no. 1; pp. 72 - 80
Main Authors:	Czarnecki, Michelle L., Hainsworth, Keri, Simpson, Pippa M., Arca, Marjorie J., Uhing, Michael R., Zhang, Liyun, Grippe, Ann, Varadarajan, Jaya, Rusy, Lynn M., Firary, Mary, Weisman, Steven J.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-02-2020
Subjects:	Analgesics, Opioid - therapeutic use Female Humans Infant Infant, Newborn Infusions, Intravenous Intensive Care Units, Neonatal - organization & administration Male Nurse-Patient Relations Nursing Outcome Assessment, Health Care - standards Outcome Assessment, Health Care - statistics & numerical data Pain Management - methods Pain Management - standards Pilot Projects
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Prospectively compare parent/nurse controlled analgesia (PNCA) to continuous opioid infusion (COI) in the post-operative neonatal intensive care unit (NICU) population. A randomized controlled trial compared neonates treated with morphine PNCA to those treated with morphine COI. The primary outcome was average opioid consumption up to 3 post-operative days. Secondary outcomes included 1) pain intensity, 2) adverse events that may be directly related to opioid consumption, and 3) parent and nurse satisfaction. The sample consisted of 25 post-operative neonates and young infants randomized to either morphine PNCA (n = 16) or COI (n = 9). Groups differed significantly on daily opioid consumption, with the PNCA group receiving significantly less opioid (P = .02). Groups did not differ on average pain score or frequency of adverse events (P values > .05). Parents in both groups were satisfied with their infant's pain management and parents in the PNCA group were slightly more satisfied with their level of involvement (P = .03). Groups did not differ in nursing satisfaction. PNCA may be an effective alternative to COI for pain management in the NICU population. This method may also substantially reduce opioid consumption, provide more individualized care, and improve parent satisfaction with their level of participation. Patients in the NICU represent one of our most vulnerable patient populations. As nurses strive to provide safe and effective pain management, results of this study suggest PNCA may allow nurses to maintain their patients' comfort while providing less opioid and potentially improving parental perception of involvement. Treatment study. I.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1524-9042 1532-8635
DOI:	10.1016/j.pmn.2019.08.002