A Pilot Randomized Controlled Trial of Outcomes Associated with Parent-Nurse Controlled Analgesia vs. Continuous Opioid Infusion in the Neonatal Intensive Care Unit.
Michelle L Czarnecki, Keri Hainsworth, Pippa M Simpson and 8 others
PMID 31494028WHAT IT FOUND
Postoperative NICU infants given parent-nurse controlled morphine used less opioid over postoperative days 0-3 than infants given continuous infusion, while pain scores stayed low and similar.
This was a small unblinded pilot.
Key findings
01Infants assigned to parent-nurse controlled analgesia with morphine used less opioid than infants assigned to continuous morphine infusion over postoperative days 0-3.
02Average daily pain scores were low and did not differ between the parent-nurse controlled analgesia and continuous infusion groups.
03Parents in the parent-nurse controlled analgesia group were more satisfied with their involvement in infant pain care, but 7 of 11 reported they never pushed the button.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The trial stopped early and included only 25 infants. The study was single-center and unblinded. The parent-nurse controlled group was managed by the Acute Pain Service and the continuous infusion group by the neonatology team. Eight infants were removed early because they received other medicines such as acetaminophen or benzodiazepines. Parent and nurse satisfaction surveys were developed by the investigators and were not validated tools. Seven of 11 parents in the parent-nurse controlled group reported they never pushed the button. The study did not determine why parents did not use the button.
Declared interests
No author conflict declaration is provided. The article is listed as NIH extramural research support.
The easy way to misread this
Do not conclude that parent-nurse controlled analgesia is proven superior for NICU pain. The trial stopped early with 25 infants, was unblinded, and 7 of 11 parents in the parent-nurse controlled group reported they never pushed the button.