Article Text


O-113 Pain Assessment In Ventilated And Non-ventilated Neonates In Nicus Across Europe: European Pain Audit In Neonates (europain Survey)
  1. R Carbajal1,
  2. M Eriksson2,
  3. E Courtois1,
  4. RD Andersen3,
  5. A Avila-Alvarez4,
  6. E Boyle5,
  7. P Lago6,
  8. K Sarafidis7,
  9. S Simons8,
  10. T Pölkki9,
  11. ML Ilmoja10,
  12. B Van Overmeire11,
  13. A Berger12,
  14. T Papadouri13,
  15. M Schroth14,
  16. R Tameliene15,
  17. S Attard Montalto16,
  18. A Dobrzanska17,
  19. C Matos18,
  20. E Europain19 Study group,
  21. L Bergqvist20,
  22. H Lagercrantz20,
  23. KJS Anand21
  1. 1Emergency Department, Hôpital Armand-Trousseau, Paris, France
  2. 2Centre for health care sciences, Örebro University Hospital, Örebro, Sweden
  3. 3NICU, Telemark Hospital, Skien, Norway
  4. 4NICU, Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain
  5. 5NICU, University of Leicester, Leicester, UK
  6. 6NICU, University of Padova, Padova, Italy
  7. 7NICU, Aristotle University of Thessaloniki, Thessaloniki, Greece
  8. 8NICU, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
  9. 9NICU, Institute of Health Sciences University of Oulu, Oulu, Finland
  10. 10NICU, Tallinn Children’s Hospital, Tallinn, Estonia
  11. 11NICU, Erasme Hospital, Bruxelles, Belgium
  12. 12NICU, Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria
  13. 13NICU, Arch. Makarios Hospital, Nicosia, Cyprus
  14. 14NICU, Cnopf’sche Kinderklinik, Nuremberg, Germany
  15. 15NICU, Perinatal Center, Kaunas, Lithuania
  16. 16NICU, Mater Dei Hospital, Msida, Malta
  17. 17NICU, Children’s Memorial Health Institute, Warsaw, Poland
  18. 18NICU, Maternidade Dr Alfredo Da Costa, Lisboa, Portugal
  19. 19Europain Study Group, Europain Study Group, Paris, France
  20. 20NICU, Karolinska University Hospital, Stockholm, Sweden
  21. 21Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA


Background Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale.

Objective To determine current clinical practices for neonatal pain assessment in NICUs across Europe.

Methods An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included.

Results From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, 58.5% of TV neonates, 45.0% of NIV neonates and 30.4% of SV neonates received bedside pain assessments (p < 0.001). Fig. shows pain assessments by country.

Abstract O-113 Figure 1

Frequency of pain assessment in tracheal ventilated (TV) neonates and non invasive ventilated (NIV) neonates admitted to NICUs in 18 European countries

Conclusions Over half (58.5%) of TV neonates and less than half (45.0%) of NIV neonates had pain assessments performed in European NICUs. Wide variations in the rates of pain assessment exist among countries and an important improvement seems necessary.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.