PEDIATRICS Vol. 80 No. 3 September 1987, pp. 446
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Neonatal Anesthesia

Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, and Section on Surgery

In the past, some practicing physicians have advocated withholding anesthetic or analgesic agents from neonates undergoing surgical procedures. The rationale expressed for such practice is that some neonates undergoing surgery are often so unstable that the risk of an anesthetic agent is too great to justify the possible benefit of pain relief. An analogy may be drawn to the adult patient with major trauma who must undergo life-saving surgery in whom anesthesia is reduced or withheld because of the fear of worsening an already compromised physiologic homeostasis.1 Also cited in support of this practice is the impression that nerve pathways are not sufficiently myelinated to transmit painful stimuli or that neonates do not have sufficiently integrated cortical function to recall painful experiences.

There is an increasing body of evidence that neonates, including those born preterm, demonstrate physiologic responses to surgical procedures that are similar to those demonstrated by adults and that these responses can be lessened with anesthetic agents.2-6 Other studies have suggested that stability of variables such as blood pressure, heart rate, and oxygenation is important in reducing complications such as intraventricular hemorrhage or pulmonary hypertension.7,8 There is also increasing evidence that neonatal cortical function is far greater than previously thought9,10 and some suggestion that short-term behavior may be affected by prior painful stimuli.11,12

The Committee on Fetus and Newborn, The Committee on Drugs, the Section on Anesthesiology, and the Section on Surgery believe that local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J Law Med EthicsHome page
R. S. Van Howe and J. S. Svoboda
Neonatal pain relief and the helsinki declaration.
J. Law Med. Ethics, December 1, 2008; 36(4): 803 - 823.
[PDF]

Home page
 PediatricsHome page
Committee on Fetus and Newborn, Committee on Drugs and Canadian Paediatric Society, Fetus and Newborn Com
Prevention and Management of Pain and Stress in the Neonate
Pediatrics, February 1, 2000; 105(2): 454 - 461.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
L. G. Maxwell and M. Yaster
Analgesia for Neonatal Circumcision: No More Studies, Just Do It
Arch Pediatr Adolesc Med, May 1, 1999; 153(5): 444 - 445.
[Full Text] [PDF]

Home page
 PediatricsHome page
R. S. Van Howe;, M. Butler-O'Hara, C. LeMoine, and R. Guillet
Pain Relief for Neonatal Circumcision: Serious Design Flaws?
Pediatrics, January 1, 1999; 103(1): 196 - 196.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
R. S. Van Howe and C. J. Cold
Neonatal Circumcision
Arch Pediatr Adolesc Med, September 1, 1998; 152(9): 931 - 931.
[Full Text] [PDF]

Home page
 PediatricsHome page
H. J. Stang and L. W. Snellman
Circumcision Practice Patterns in the United States
Pediatrics, June 1, 1998; 101 (6): e5 - e5.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. R. Howard, F. M. Howard, L. C. Garfunkel, E. A. de Blieck, and M. Weitzman
Neonatal Circumcision and Pain Relief: Current Training Practices
Pediatrics, March 1, 1998; 101(3): 423 - 428.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
H. J. Stang, L. W. Snellman, L. M. Condon, M. M. Conroy, R. Liebo, L. Brodersen, and M. R. Gunnar
Beyond Dorsal Penile Nerve Block: A More Humane Circumcision
Pediatrics, August 1, 1997; 100(2): e3 - e3.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
P. M. Fleiss, L. M. Robson, A. K.C. Leung, R. S. Van Howe, and G. Weiss
A Perspective on Controversies About Neonatal Circumcision
Clinical Pediatrics, July 1, 1995; 34(7): 395 - 399.
[PDF]

Home page
 Clin Nurs ResHome page
M. J. Dick
Preterm Infants in Pain: Nurses' and Physicians' Perceptions
Clin Nurs Res, May 1, 1993; 2(2): 176 - 187.
[Abstract] [PDF]

Home page
 JAMAHome page
H. J. Stang, M. R. Gunnar, L. Snellman, L. M. Condon, and R. Kestenbaum
Local Anesthesia for Neonatal Circumcision: Effects on Distress and Cortisol Response
JAMA, March 11, 1988; 259(10): 1507 - 1511.
[Abstract] [PDF]