CHAPTER 26 Pain Assessment and Management
Recognition and treatment of pain in neonates is an emerging science and is controversial. To effectively treat pain in neonates, the maturity and function of many different body systems must be considered (Figure 26-1). Choosing appropriate drug therapy requires consideration of course, cause, and severity of pain and the duration and side effects of the chosen analgesic therapy (Box 26-1). In addition, other medications, concurrent medical problems and medications, and the patient’s physical status should be considered when choosing analgesics. Few clinical studies have been conducted investigating pain in neonatal dogs and cats. All too often, pain in neonates and juvenile animals is undertreated.
BOX 26-1 Clinical implications of immaturity
Physiology and Development
Drug Absorption, Metabolism, and Excretion
Physiology and Pathophysiology of Pain in Neonates
Pain Control
Sedatives
Acepromazine
TABLE 26-1 Drugs useful for treating pain in neonates
Drug | Dose |
---|---|
Phenothiazine Tranquilizers | |
Acepromazine | 0.01-0.05 mg/kg IM, SC |
Benzodiazepines | |
Diazepam | 0.1-0.4 mg/kg IV |
Midazolam | 0.1-0.4 mg/kg IV, IM |
Alpha-2 Agonists | |
Medetomidine | |
Xylazine | 1-2 mg/kg IM |
Opiates | |
Morphine | 0.2-1 mg/kg IM |
Oxymorphone | 0.02-0.2 mg/kg IV, IM, SC |
Hydromorphone | 0.02-0.2 mg/kg IV, IM, SC |
Fentanyl | 0.002-0.004 mg/kg IV, IM |
Fentanyl patches | |
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