Pain and Analgesia in Newborns-Development of a Neonatal Pain Ladder.

Preventing and relieving pain in newborns represent humane and ethical imperatives. Unrelieved and repetitive pain can cause adverse short- and long-term consequences including neurodevelopmental impairment. Increased awareness and routine assessment of pain can help direct the use of nonpharmacologic interventions and/or analgesic and sedative drugs. A Pain and Analgesics In Newborns ladder is proposed to facilitate appropriate interventions commensurate with the severity of pain. Although neonatal pain assessment tools remain highly subjective and under scrutiny, pain intensity scores using validated pain scoring tools should be routinely recorded as vital signs to assess pain severity and guide interventions to provide comfort and improve outcomes.