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EPN 2021

Dulce Cruz

Dulce Cruz, Speaker at Pediatrics Conferences
University of Evora, Portugal
Title : Signalization of predictive factors to increase pain management practices in neonates


Introduction: We aimed to better understand what predicts the frequency and analgesia of procedural pain in neonates.

Methods: An observational prospective cohort study was made. We analyzed data from 375 neonates in 19 neonatal intensive care units of Portugal, including 6705 painful procedures. We used generalized linear models to identify variables related to the incidence of painful procedures and analgesia.

Results: Each neonate endures a mean of 5.4 painful procedures per hospitalization day. There is a higher frequency of painful procedures in very preterm babies and with high severity of disease. Overall, 5053 (75.1%) painful procedures were performed with analgesia according to guidelines. The lack of optimal preprocedural analgesia was associated with the first two days of neonatal care, lower gestational age of the infants, neonates with respiratory support, needle procedures, parental absence, and units with less organizational culture of pain management.

Conclusion: Recognizing neonates at high risk, the high incidence of painful procedures, as well the identification of the main factors associated to neonatal procedural pain management, allows a better care for pain prevention and protection of premature and/or sick babies in neonatal intensive care units.

Key Words: Neonatal care, Painful procedures, Prevention of pain


Dulce last year finished her PhD studies in Health Science, at Faculty of Medicine of University of Coimbra, Portugal. The focus of her thesis was about Epidemiology of Pain in Neonatal Intensive Care Units. Her background was on Pediatric Nursing. Since 2007 she is Adjunct Professor at Évora University, School of Nursing, and received her Sociology MSc degree in 2006 at the same institution. She joined in 2012 as a trainee membership to a transdisciplinary and international research training consortium - Pain in Child Health, an initiative to promote the development of health researchers in pediatric pain.